We present a case of a 67 year old man who was admitted to hospital 4 days after an episode of severe chest pain. His coronary angiogram showed occlusion of the distal right coronary artery consistent with a delayed presentation of an inferior AMI. He was then found to have loud murmur. Echocardiography showed a 17mm defect in the inferior-basal ventricular septum, establishing a diagnosis of post-MI VSD. He remained stable on medical treatment. Six weeks later we performed surgical repair of the VSD. This video shows the technique we used in this case. The patient went on to make a good recovery.