Postinfarction ventricular septal defect (VSD) is an uncommon but almost lethal complication. The optimal timing for VSD repair is matter of debate, and mechanical circulatory support (MCS) devices allow to hemodynamically support the patient and postpone the VSD closure until myocardial tissue is less friable and the patient's condition is less compromised. However, data are lacking to guide the choice of the best types of MCS in case of VSD. We present a case of a large postinfarction VSD and the use of central venoarterial extracorporeal membrane oxygenation support to stabilize the patient until the VSD surgical repair. This case offers the opportunity to revise the indications and characteristics of different MCS, highlighting pros and cons of each one.
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