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Since 1994, three patients more than 80 years of age underwent early repair of ventricular septal rupture complicating acute myocardial infarction at our hospital. The infarction exclusion technique introduced by David and Komeda was employed. Average aortic clamp time, cardiopulmonary bypass time and operation time were 83 minutes, 129 minutes and 228 minutes, respectively. No hemostatic suture were required to the left ventricular suture line. All patients survived. One patient with posterior ventricular septal rupture had residual shunt and necessitated transient hemodialysis but recovered. Thus, the infarction exclusion technique seems to be useful in the elderly with unfavorable tissue fragility.

A case of unilateral pulmonary vein atresia in a 20-month-old girl is described in this report. A chest X-ray revealed a reticular shadow on the right side, while an electrocardiogram revealed right ventricular hypertrophy. After cardiac catheterization and angiography, a diagnosis of a ventricular septal defect, patent ductus arteriosus, severe pulmonary hypertension, and atresia of the right pulmonary vein was made. The patient underwent an operation for the ventricular septal defect and ligation of the patent ductus arteriosus. During the operation, the right pulmonary vein was found to be atretic, and unrepairable. Pneumonectomy was not performed because the pulmonary arterial pressure decreased to 41 mmHg after the surgical treatment of the intracardiac lesions. Pneumonectomy will be necessary if one or more complications such as persistent hemoptysis, repeated pulmonary infections or the development of pulmonary hypertension, may occur in future.