Ruptured papillary muscle after mitral valve replacement with preservation of chordae tendineae

Lemke, P.; Roth, Matthias; Kraus, Brigitte; Hohe, S; Klövekorn, W. P.; Bauer, Erwin

doi:10.1016/s0003-4975(00)02502-9

Cited by 11 publications

(7 citation statements)

References 5 publications

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“…[9][10][11][12][13] Some of the produced preservation techniques with alternation of the left ventricular geometry may cause rupture of the papillary muscles or dehiscence of mitral leaflets from transposed position. [18][19][20][21] Systemic embolization had been reported in some of these studies. 18,19 We presented the results of our modified technique of bileaflet preservation 22 during MVR, which eliminates risk of LVOT obstruction and rupture of the 2004;19:528-534 MODIFIED ANTERIOR LEAFLET PRESERVATION TECHNIQUE papillary muscles or dehiscence of mitral leaflets from transposed position.…”

mentioning

confidence: 99%

Both Leaflet Preservation During Mitral Valve Replacement:. Modified Anterior Leaflet Preservation Technique

Cingoz

Günay

Kuralay

et al. 2004

Journal of Cardiac Surgery

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mentioning

confidence: 99%

Both Leaflet Preservation During Mitral Valve Replacement:. Modified Anterior Leaflet Preservation Technique

Cingoz

Günay

Kuralay

et al. 2004

Journal of Cardiac Surgery

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“…This complication was first described in 1984 6 . Subsequently, only four additional cases 7–9 have been reported in the English‐speaking literature. In three of the reported cases, the complication was fatal (all of these patients had received a tilting‐disc mechanical prosthesis).…”

Section: Discussionmentioning

confidence: 99%

Papillary Muscle Rupture: An Unusual Complication of Chordal Sparing Mitral Valve Replacement

Long

MEd

2010

Journal of Cardiac Surgery

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An adult patient with advanced rheumatic heart disease undergoing chordal sparing mitral valve replacement as well as aortic valve replacement is presented. The patient developed an unusual complication of an infarction of the retained head of the anterolateral papillary muscle with subsequent spontaneous rupture 72-hours postoperatively. The ruptured head of the papillary muscle was successfully resected via an aortotomy through the aortic valve prosthesis. The patient made an uneventful recovery. Care to avoid excessive tension on the preserved chordae during mitral valve replacement, especially in the setting of chronic rheumatic carditis, is stressed.

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“…The retained chordate/leaflet may affect the opening and closure of implanted mechanical or bioprosthetic valve, and rupture of the papillary muscle due to excessive pull in the chordae tenedineae has also been described. 5 However, the attachments between papillary muscles and mitral annulus are believed to be important for ventricular function and they may be even more so in patients with impaired ejection fraction who need mitral valve surgery. Obviously mitral valve repair is the best option because it keeps the ventriculo-annular attachments intact, but because this is not always feasible in patients with ischemic mitral regurgitation and impaired ventricular function, mitral valve replacement with preservation of at least the poste-rior leaflet is probably the next best approach.…”

Section: Discussionmentioning

confidence: 99%

Ischemic Mitral Regurgitation: Chordal-Sparing Mitral Valve Replacement

David

2012

Operative Techniques in Thoracic and Cardiovascular Surgery

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I n 1964, Lillehei and colleagues introduced the concept of preservation of the attachments between the papillary muscles and mitral annulus during mitral valve replacement to prevent postoperative left ventricular dysfunction. 1 This concept was challenged by other investigators and largely abandoned until 1983 when we reexamined the issue and found that the attachments between the papillary muscles and mitral annulus were important for postoperative ventricular function in patients with mitral insufficiency. 2 This can be accomplished when the mitral insufficiency is corrected by means of mitral valve repair or mitral valve replacement with preservation of the chordae tendineae. 2 We also found that mitral valve replacement with preservation of chordae tendineae reduced operative mortality and enhanced late survival in patients with ischemic mitral insufficiency. 3 This article describes the technique we have used to preserve the attachments between the papillary muscles and mitral annulus during mitral valve replacement for ischemic mitral insufficiency.

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Ruptured papillary muscle after mitral valve replacement with preservation of chordae tendineae

Cited by 11 publications

References 5 publications

Both Leaflet Preservation During Mitral Valve Replacement:. Modified Anterior Leaflet Preservation Technique

Both Leaflet Preservation During Mitral Valve Replacement:. Modified Anterior Leaflet Preservation Technique

Papillary Muscle Rupture: An Unusual Complication of Chordal Sparing Mitral Valve Replacement

Ischemic Mitral Regurgitation: Chordal-Sparing Mitral Valve Replacement

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