Left ventricular rupture as a complication of mitral valve replacement

Björk, Viking Olov; Henze, Axel; Rodriguez, L. Leonardo

doi:10.1016/s0022-5223(19)39977-5

Cited by 96 publications

(23 citation statements)

References 6 publications

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“…The incidence ranged from 0.5% of 1154 MVR by Zacharias and coworkers to 14% of 14 procedures performed by Stephenson and associates . Pooling of the data from 12 institutions on 12,988 patients undergoing MVR revealed a 0.74% incidence of left ventricular rupture (Table 1) [2,3,7,8,18,19,22,[26][27][28]. In a series of 5449 patients who underwent MVR from 1995 through 2003, Zhang and colleagues reported a 0.24% prevalence of LV rupture in association with a 61.5% mortality rate [15].…”

Section: Incidencementioning

confidence: 99%

“…Collected data from the published literature identified 108 patients for whom the classification was possible; 50 had type I and 58 had type II or III ruptures. The overwhelming majority of the ruptures in these 58 patients were type III [2,3,7,8,18,19,22,[26][27][28]. Failure of transapical off-pump mitral valve repair with Neo-chordal implantation (DS 1000; NeoChord Inc, St. Louis Park, Minnesota, USA) have introduced a new subset of patients with rupture site located between the base of the papillary muscle and ventricular apex [17].…”

Section: IVmentioning

confidence: 99%

“…Pre-existing intrinsic myocardial disease especially rheumatic, ischemic, infectious processes and renal failure requiring hemodialysis have also been implicated. Hypothermic cardioplegia has been implicated in left ventricular rupture through: i) increased susceptibility of the cardiopleged muscle to stretch injury [11,12] [2,3,7,8,18,19,22,[26][27][28]. In this entire group, only the bioprosthesis was directly implicated in initiating the myocardial injury.…”

Section: Etiopathogenesismentioning

confidence: 99%

“…Posterior rupture of the left ventricle has been a recognized complication since the inception of mitral valve surgery, and ironically, despite advances in cardiac anaesthesia, intensive care, and advances in virtually the entire spectrum of valvular heart surgeries, the outcome of left ventricular rupture has remained dismal with a reported mortality between 50-93% [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. It is a catastrophic complication with lethal consequences, which is manifested by massive hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

“…It is a catastrophic complication with lethal consequences, which is manifested by massive hemorrhage. The clinical scenario gets worsened if the rupture occurs after the chest is closed and the patient is out of operation theatre [2,3,7,11,12]. Our knowledge regarding left ventricular rupture following mitral valve repair and replacement has been gained from isolated sporadic case reports that have been published over the span of more than 50 years [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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A Treatise on The Surgical Management and A Suggested Amendment of Surgical Classification of Left Ventricular Rupture Following Mitral Valve Replacement

Gudala¹,

Chauhan²,

Jena³

et al. 2019

JICOA

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The present perspective is a synthesis of 108 published investigations in the setting of different types of left ventricular rupture following mitral valve replacement (MVR). We identified 109 investigations and reviewed the clinical presentation, diagnostic modalities, surgical techniques and outcomes. Clinical presentation, roentgenography, cross-sectional transthoracic/transesophageal echocardiography and computerized tomography provided the diagnostic information and defined the causative mechanism. Magnetic resonance imaging had been used for further clarification of the native ventricular anatomy in high-risk subset of patients, undergoing non-traditional transapical off-pump mitral valve repair with neochordal implantation. In this article, we have attempted to address several concerning issues and controversies with reference to the possible causative mechanisms, preventive measures, the issue of chordal preservation during MVR, the degree of decalcification required in cases of heavily calcified mitral annulus, selection of appropriate sized prosthetic valves, the surgical importance of a small left ventricle, various techniques of repair, role of cardiopulmonary bypass and cardioplegic arrest during the repair of left ventricular rupture, the role of biodegradable epicardial tissue sealants, to repair or not to repair the atrio-ventricular groove hematoma during mitral valve surgery, and the role of intra-aortic balloon counterpulsation in the perioperative period. Additionally, we have highlighted a new type of left ventricular rupture described in the literature located between the base of the papillary muscle and the apex, which can be categorized as a complication of new technologies of mitral valve repair such as NeoChord device artificial chordal implantation. We have classified this category as type IV ventricular rupture. Overall, this review attempts to address the guidelines for different surgical approaches and techniques of repair of different types of left ventricular rupture for a successful outcome. We submit that an increased appreciation of the causative mechanisms of different types of left ventricular rupture and its prevention may well contribute to improved surgical management.

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Section: Incidencementioning

confidence: 99%

Section: IVmentioning

confidence: 99%

Section: Etiopathogenesismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A Treatise on The Surgical Management and A Suggested Amendment of Surgical Classification of Left Ventricular Rupture Following Mitral Valve Replacement

Gudala¹,

Chauhan²,

Jena³

et al. 2019

JICOA

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Systolic compression of the right coronary artery by a pseudoaneurysm following mitral valve replacement

Minami

Fergusson

1989

Cathet. Cardiovasc. Diagn.

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A patient who developed a pseudo-, or false, aneurysm following mitral valve replacement is presented here with the unique angiographic finding of systolic compression of the right coronary artery by the pseudoaneurysm. Clinical and angiographic features of this case along with a discussion of pseudoaneurysms and the significance and causes of systolic compression of coronary arteries are presented.

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