Repair of ventricular septal rupture after acute myocardial infarction remains a surgical challenge. Several techniques for the closure of these defects have been described. This report discusses an infarct exclusion technique modified from the one described by Tirone David and associates. In this technique two separate pericardial patches are used. The first patch excludes the rupture. The second patch is Comment VSR is a surgical emergency. Various techniques have developed over time. The presence of residual VSDs, LV

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Accidental entry into the right ventricular cavity is a common occurrence during exposure of the intramyocardial left anterior descending artery. Several techniques have been described for repair of the perforation. Although these methods can be used, there is still a danger of persistent bleeding or distal ischemia. We describe a method that is safe and reproducible.