Left ventricular rupture postmitral valve replacement: Surviving a catastrophe

Bisoyi, Samarjit; Mohanty, Jitendu; Mohapatra, Raghunath; Nayak, Debashish

doi:10.4103/0971-9784.148327

Cited by 10 publications

(10 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Rupture of the LV wall after MVR, although infrequent, could be a fatal complication and as such requires early diagnosis and planning for surgical intervention (6,7). LV pseudoaneurysms can be classified into 3 types according to the location of the rupture (8). In type I, the perforation of the thin attachment of the atrium to the ventricle happens in the posterior atrioventricular groove.…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Pseudoaneurysm After Mitral Valve Replacement

Poorzand¹,

Fani²

2016

Arch Cardiovasc Imaging

View full text Add to dashboard Cite

Introduction: Left ventricular (LV) pseudoaneurysms due to late rupture after mitral valve replacement (MVR) are very rare. Surgical management of LV pseudoaneurysms is inevitable because of their potential risk of enlargement and rupture. Case Presentation: A 53-year-old woman was referred to our echocardiography lab because of exertional dyspnea. She had recently undergone MVR and had an uneventful in-hospital course. Echocardiographic study revealed an LV pseudoaneurysm, just below the annulus in the left atrioventricular groove. She refused repeated surgery at this stage. Conclusions: Rupture of the LV wall after MVR could be a fatal complication. Echocardiography is the most widely used method for the diagnosis of LV pseudoaneurysms. Cardiologists should be aware of this complication and consider it while assessing MVR cases.

show abstract

Section: Discussionmentioning

confidence: 99%

Left Ventricular Pseudoaneurysm After Mitral Valve Replacement

Poorzand¹,

Fani²

2016

Arch Cardiovasc Imaging

View full text Add to dashboard Cite

show abstract

“…ecocardiograma transesofágico intraoperatorio juega un rol importante en la identificación de los pacientes en riesgo y en establecer el diagnóstico temprano seguido de una inmediata intervención quirúrgica. (1), (7) Muchas técnicas de reparo han sido descritas para reparar la ruptura del ventrículo izquierdo incluyendo el uso de la técnica de sándwich (8) , técnica de translocación parcial (9) , pericardio bovino y sutura continua (3), (10) , pericardio bovino y otro tipo de sellante diferente al usado en nuestro caso y soportado con balón de contra pulsación (11) , pero de manera general, estas técnicas se pueden clasificar en abordaje interno y abordaje externo. El abordaje interno incluye el cierre directo de la lesión con suturas reforzadas o con parche que cubre la lesión fijado al endocardio intacto del ventrículo y la aurícula a través del anillo, luego de haber retirado la prótesis valvular (6) .…”

Section: Rfs Revista Facultad De Saludunclassified

“…Los factores de riesgo, implicados en la presentación de la ruptura ventricular relacionados con cirugía de la válvula mitral, son la edad avanzada, enfermedad reumática del corazón, excesiva calcificación del aparato de la válvula mitral, sexo femenino, isquemia miocárdica, endocarditis infecciosa con absceso del anillo, enfermedad miocárdica, hemodiálisis y ventrículo pequeño (diámetro de fin de diástole menor de 50 mm). Los factores de riesgo intraoperatorio que pueden precipitar la ruptura son causas mecánicas, como la excesiva resección de las valvas mitrales, el anillo y/o el músculo papilar; adherencias de una operación previa, prótesis de gran tamaño, suturas profundas en el miocardio, retracción forzada en el anillo mitral y del ventrículo izquierdo (1) . Esta paciente, de edad avanzada, tenía como factor predisponente más importante el miocardio muy friable para que se presentara la ruptura.…”

Section: Conclusiónunclassified

See 1 more Smart Citation

Disrupción auriculoventricular durante una plastia de la válvula mitral y corrección con parche de pericardio y Bioglue®

Núñez¹,

Tovar²,

Franco³

et al. 2016

RFS

View full text Add to dashboard Cite

La disrupción auriculoventricular después de un cambio de la válvula mitral es una complicación rara, sin embargo presenta altos índices de mortalidad. Este es el primer reporte de un caso de ruptura ventricular luego de una plastia mitral en una paciente femenina de 69 años llevada a plastia mitral y tricuspídea. Después de terminar la perfusión cardiopulmonar, se observó ruptura ventricular localizada en el surco auriculoventricular, el desgarro fue reparado externamente con un parche de pericardio y adhesivo quirúrgico biológico. La paciente se recuperó y fue dada de alta sin complicaciones. Se discute acerca de la etiología y el reparo quirúrgico de esta complicación.

show abstract

“…A) Placement of multiple interrupted mattress sutures reinforced with Teflon felt pledgets (P). B) A large, two-way stretch Dacron patch (D) was subsequently placed on the epicardial surface to healthy myocardial tissue at a distance from the laceration using a running 5-0 polypropylene suture Use of two-Teflon strips over the rupture site: Bisoyi and associates have successfully repaired a type III LV rupture using buttresses of strips of Teflon re-inforced with prolene sutures[79].…”

mentioning

confidence: 99%

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

View full text Add to dashboard Cite

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.

show abstract

Left ventricular rupture postmitral valve replacement: Surviving a catastrophe

Cited by 10 publications

References 16 publications

Left Ventricular Pseudoaneurysm After Mitral Valve Replacement

Left Ventricular Pseudoaneurysm After Mitral Valve Replacement

Disrupción auriculoventricular durante una plastia de la válvula mitral y corrección con parche de pericardio y Bioglue®

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

Contact Info

Product

Resources

About