Complications of acute myocardial infarction that develop within the first 2 weeks after its onset have been associated with a poor prognosis and dismal surgical outcome. In recent years, aggressive use of hemodynamic monitoring and interventions that improve myocardial oxygen supply and demand have noticeably altered the prognosis. Urgent relief of myocardial ischemia with coronary reperfusion has had the largest impact in improving the results. Surgical treatment of mechanical and nonmechanical complications of acute myocardial infarction requires prompt decision making and expeditious implementation. Persistent left ventricular dysfunction and cardiogenic shock are the most important factors that influence the overall results.