A hole in the heart, occurring after heart attack is a rare but life threatening condition. 94% of the patients die if no surgery is done. Even in the best hands, surgery to close such holes in the heart can save only 53% of patients. Complications are higher if the patient comes to the hospital after 24 hours of heart attack. Because of the facilities of emergency angioplasty, these holes in the heart have become very rare (0.3%) now. A 51-year-old diabetic and hypertensive lady suffered a major heart attack. She went to a hospital and got angiography and angioplasty with stenting in the culprit vessel done. But she continued to deteriorate even after the procedure and was brought to SSB hospital, Faridabad in very critical condition with extremely low BP. Dr S.S. Bansal, CMD and senior interventional cardiologist reviewed the patient and found that the ventricular septum had ruptured and heart function was very low. She was very critical and immediately the case was discussed with Dr (Brig.) S.S. Sidhu, chief cardiac surgeon at SSB hospital. He stabilized the patient with intra-aortic balloon pump (IABP) and did emergency surgery to save the life of the patient. The patient underwent patch repair of the large hole in the septum and a bypass surgery with balloon support by Dr Sidhu, Dr Pankaj Ingole and Dr Neelam Aggarwal. Postoperatively, there was a gradual improvement in patient’s condition. The patient was taken off the ventilator and balloon pump on the 3rd postoperative day, and she covered very fast. She was soon discharged in good condition. Most of these patients do not survive. However, this patient could be saved due to 24x7 critical care, prompt team work and meticulous surgery. "Only a dedicated and motivated cardiac and cardiothoracic team can save such high-risk patients,” says Dr. S.S. Bansal.