Perforation of the interventricular septum as a complication of acute myocardial infarction has been reported with increasing frequency and has been periodically reviewed.1-3 The condition was first described anatomically by Latham4 in 1845. The first antemortem diagnosis was made in 1923 by Brunn.5 Sager1 in his review of 18 cases in 1934 stressed that the diagnosis can be made from the sudden appearance of a murmur, which resembles that heard in congenital ventricular septal defect in a patient who has had a recent acute myocardial infarction. In recent years, most reported cases have been diagnosed ante mortem and some have been confirmed by cardiac catheterization.3,6-9 The first attempt at surgical correction of this acquired defect was made by Cooley et al.7 in 1957. At the present time, 116 years after Latham's initial description, the world literature contains approximately 220 cases. The recent advances in