Mean number of emergency surgery for post infarction ventricular septal perforation( VSP) in Japan from 2001 to 2018 was 235 cases/year, with 35.2% of in hospital mortality. There was no apparent improvement in surgical results in Japan, nor worldwide for this disease during last two decades. In this report, overview of current surgical techniques for VSP was described. Infarction exclusion technique, entire septal patch technique, and sandwich technique through right ventricle incision were summarized. To further improve surgical results for VSP, pre-operative mechanical assist in critically ill patients, or development of new surgical technique using plug device may be necessary.
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