Tricuspid valvectomy to facilitate repair of postinfarction ventricular septal defect

Repair of postinfarction ventricular septal defect (VSD) located posteriorly can be a challenging procedure both in regard to operative mortality and recurrence of the defect. Avoidance of ventriculotomy by transatrial repair may decrease risks of bleeding and impairment of ventricular function secondary to suture placement; however, adequate exposure of the defect through the tricuspid valve is not always possible. We present a case of successful transatrial repair of posterior postinfarction VSD with concurrent tricuspid valvectomy and coronary artery grafting.