ObjectiveTo explore our novel strategy of surgical treatment for ventricular septal rupture (VSR) and the long-term outcomes.MethodsAll the patients referred to the Center of Adult Surgery, Fuwai Hospital were treated with integration treatment of vasoactive agents, intra-aortic balloon pump, or left ventricular assist device. The timing of surgical treatment was individually customized. One hundred and five consecutive patients with VSR (63 males, 42 females ) presented at the mean age of 63 (range, 41 to 80) years. We retrospectively analyzed the results and followed up patients who survived the surgical procedure.Results They were divided into a hemodynamics stable group (25 patients, 2 received emergent operation and 23 received selective operation) and a hemodynamics unstable group (80 patients, 34 received vasoactive agents and selective operation, 4 received vasoactive agents and emergent operation, 20 received vasoactive agent, intra-aortic balloon counterpulsation (IABP), and selective operation, 16 received vasoactive agents, IABP, and emergent operation, 2 received vasoactive agents, IABP, ventilator support, and selective operation, 2 received vasoactive agents, IABP, and ventilator support and emergent operation, 2 received vasoactive agents, ventilator support, and selective operation). There were 3 in-hospital deaths. Ninety-nine patients were followed up, with a follow-up rate of 97.1%. The mean follow-up time was 76.56±47.78 months. There were 2 late deaths during follow-up.ConclusionThe timing of surgical treatment for ventricular septal rupture should be individually customized. The long-term outcomes of ventricular septal rupture patients who survived the surgery are satisfactory.