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Ventricular septal defect concurrent with left ventricular aneurysm is unusual in postinfarction patients. The complex anatomy is challenging for occluder deployment in transcatheter closure and associated with high risk of aneurysm perforation. Present a case of transcatheter closure of a large postinfarction ventricular septal defect with an Amplatzer septal occluder in a 71-year-old woman, complicated with aneurysm rupture and cardiac tamponade and corrected with surgical repair.