A 75-year-old woman was admitted complaining of anterior chest pains, and peripheral coldness. The 6th day after admission, a loud systolic murmur of Levine IV/VI was audible at the apex. The chest X-ray film demonstrated a cardiomegaly and ST elevation in the V1-V5 leads. UCG and right-heart catheterization revealed an intraventricular shunt from left to right, and the diagnosis of ventricular septal perforation after acute antero-septal myocardial infarction was confirmed. Although, we were continuing and aggressive medical treatment with the intraaortic balloon pumping, an emergency operation for ventricular septal perforation was performed, 15 days after onset. The direct closure of the septal perforation and the plication of the left ventricular free wall with two felt strips were performed. The postoperative course seemed well. But in the 3rd postoperative day, massive bleeding was recognized through the drainage tube. The left ventricular rupture was suggested, and a massive blood transfusion was done. An emergency operation was performed. Another left ventricular free wall was lacerated about 6 mm at the apex. The laceration was closed with teflon felt strips. The patient survived through the operation, and is doing well after 7 years since the operation.