Repair of delayed left ventricular rupture after mitral valve replacement: report of a case

• Published in: Surgery today (Tokyo, Japan) Vol. 34; no. 11; pp. 958 - 960
• Main Authors: Terada, Hitoshi, Kazui, Teruhisa, Yamashita, Katsushi, Washiyama, Naoki, Suzuki, Takayasu, Suzuki, Kazuchika, Ohkura, Kazuhiro, Hasan Muhammad, Bashar Abul
• Format: Journal Article
• Language: English
• Published: Japan 01-11-2004
• Subjects: Bioprosthesis - adverse effects; Female; Follow-Up Studies; Heart Rupture - diagnosis; Heart Rupture - etiology; Heart Rupture - surgery; Heart Valve Prosthesis Implantation - adverse effects; Heart Valve Prosthesis Implantation - methods; Humans; Middle Aged; Mitral Valve Stenosis - diagnosis; Mitral Valve Stenosis - surgery; Postoperative Complications - diagnosis; Postoperative Complications - surgery; Reoperation; Risk Assessment; Surgical Flaps; Time Factors; Tissue Adhesives - therapeutic use; Treatment Outcome
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-004-2844-z

Rupture of the left ventricle (LV) after mitral valve replacement (MVR) is a devastating complication, associated with high mortality. A 64-year-old woman with a type I delayed LV rupture, which occurred after MVR with a 27-mm St. Jude Medical mitral prosthesis for mitral stenosis, was successfully treated by a combination of intracardiac and extracardiac surgical repair techniques. The extracardiac repair involved approximating the edges of myocardium around the tear with large sutures bolstered by strips of Teflon felt, then covering the epicardial hematoma with another porcine pericardial patch, using gelatin resorcinol formaldehyde glue and collagen sheets. The intracardiac repair involved suturing the edges of an oval piece of porcine pericardium to the endocardium around the laceration. No LV pseudoaneurysm was detected postoperatively on echocardiography or computed tomography scans. The patient is well 2 years after the operation.