Epicardial Repair of Acute Atrioventricular Groove Disruption Complicating Mitral Valve Replacement: A case report.
- Author:
Kwang Ree CHO
1
;
Sung Hoon JIN
;
Jae Geul KANG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Halla General Hospital. jinshdr@yahoo.co.kr
- Publication Type:Case Report
- Keywords:
Ventricular rupture;
Mitral valve, surgery;
Rupture
- MeSH:
Cardiopulmonary Bypass;
Female;
Heart Ventricles;
Hemorrhage;
Humans;
Japan;
Middle Aged;
Mitral Valve Stenosis;
Mitral Valve*;
Polytetrafluoroethylene;
Rupture;
Sutures;
Tricuspid Valve Insufficiency;
Weaning
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2007;40(12):855-858
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A left ventricular rupture might be one of the most disastrous complications after a mitral valve replacement. An acute atrioventricular groove rupture (type I) was detected in a 54-year-old female diagnosed with a mitral stenosis combined with severe tricuspid regurgitation. She had a prior medical history of an open mitral commissurotomy in Japan at 30 years ago. The surgical findings suggested that the previous procedure was not a simple commissurotomy but a commissurotomy combined with a posteromedial annuloplasty procedure. After a successful mitral valve replacement and a measured (De Vega type) tricuspid annuloplasty, the weaning from a cardiopulmonary bypass was uneventful. However, copious intraoperative bleeding from the posterior wall was detected and the cardiopulmonary bypass was restarted. Exposure of the posterior wall of the left ventricle showed bleeding from the atrioventricular groove 3 cm lateral to the left atrial auricle. Under the impression of a Type I left ventricular rupture, epicardial repair (primary repair of the Teflon felt pledgetted suture, continuous sealing suture using auto-pericardial patch and application of fibrin-sealant) was attempted. Successful local control was made and the patient recovered uneventfully. The patient was discharged at 14 postoperative days without complications. We report this successful epicardial repair of an acute type I left ventricular rupture after mitral valve replacement.
