Abstract

Link of Video Abstract: https://youtu.be/LZnyDExOr9w Background: Ventricular septal defect (VSD) is the most common congenital cardiac anomaly in children and the second most common in adults. It often coexists with other cardiovascular conditions, including hypertension, coronary artery disease (CAD), and heart failure. This presents unique challenges in diagnosis and treatment. Case Presentation: We present the case of a 46-year-old woman with a previously undiagnosed VSD complicated by a ventricular septal rupture and prior myocardial infarction. Coronary artery bypass grafting (CABG) and VSD repair were performed. Unexpectedly, the VSD turned out to be an atrial septal defect (ASD) of the muscular type. The repair was successful using mattress sutures and a 0.6mm PTFE patch. Two-coronary-artery bypass was also performed. The patient's recovery was uneventful, with no residual VSD. Conclusions: Discovering a large, asymptomatic VSD in an elderly patient is uncommon. Simultaneous repair of VSD and CAD yields favorable surgical outcomes, highlighting the importance of thorough preoperative evaluation in such cases.

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