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J Thorac Cardiovasc Surg 2006;132:428-430
© 2006 The American Association for Thoracic Surgery

Brief Communication

The disk of bileaflet mechanical mitral valve prosthesis jammed by ruptured papillary muscle

Marcin Fijalkowski, MD * , Andrzej Koprowski, MD, PhD, Rafal Pawlaczyk, MD, PhD, Piotr Siondalski, MD, PhD, Rafal Galaska, MD, Jan Rogowski, MD, PhD, Andrzej Rynkiewicz, MD, PhDGdanskPoland

First Department of Cardiology and Department of Cardiosurgery, Medical University of Gdansk, Gdansk, Poland

Received for publication April 10, 2006; accepted for publication April 20, 2006.

* Address for reprints: Marcin Fijalkowski, MD, First Department of Cardiology and Department of Cardiosurgery, Medical University of Gdansk, ul. Debinki 7, 80-952 Gdansk, Poland (Email: mfijalkowski@amg.gda.pl).

The first 20% of the full text of this article appears below.

The incidence and natural history of papillary muscle rupture occurring after chord-sparing mitral valve replacement for ischemic mitral insufficiency are unknown. A case in which this complication occurred after chord-sparing mitral valve replacement is described.

Clinical Summary

A 59-year-old man was admitted to our institution with acute heart failure symptoms and chest discomfort lasting for 3 days. The electrocardiogram showed sinus tachycardia (115 beats/min) and pathologic Q waves in the II, III, and aVF leads. The serum concentrations of creatine kinase MB and troponin I were significantly elevated. A chest radiograph revealed pulmonary edema. Two-dimensional transthoracic echocardiography showed akinesia of inferior and posterior walls and severe mitral regurgitation caused by posterior leaflet restriction (vena contracta 7 mm). Coronary angiography showed occluded right and circumflex coronary arteries and a critically narrowed left anterior descending coronary artery.

On the basis of these findings, mitral valve surgery and coronary artery bypass grafting were recommended. Treatment with intra-aortic balloon pump support was started, without significant improvement. Emergency cardiosurgery was . . . [Full Text of this Article]






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