Mitral Valve Replacement for Mitral Regurgitation Caused by Papillary Muscle Rupture 8 Months after Onset.
10.4326/jjcvs.29.351
- VernacularTitle:弁置換，三尖弁形成，冠動脈バイパスを施行した後乳頭筋断裂による僧帽弁閉鎖不全症の１治験例
- Author:
Noboru Wakita
;
Hiroya Minami
;
Ikurou Kitano
;
Masahiro Sakata
;
Tsutomu Shida
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2000;29(5):351-353
- CountryJapan
- Language:Japanese
-
Abstract:
Mitral regurgitation caused by papillary muscle rupture has a poor prognosis and should be operated on soon after onset. We recently encountered a patient who was operated on 8 months after the onset of mitral regurgitation caused by rupture of the posterior papillary muscle. The patient was a 72-year-old man who was admitted as an emergency case for acute left heart failure due to severe mitral regurgitation. As medical treatment was effective, he refused to have mitral valve surgery. Six months later, he was admitted to our hospital complaining of nocturnal orthopnea and underwent surgical treatment. Severe mitral regurgitation with postero-medial papillary muscle rupture was revealed by transesophageal echocardiography. Coronary angiography showed 90% stenosis of the proximal left circumflex artery. At 8 months after the onset of mitral regurgitation, the patient underwent successful scheduled mitral valve replacement together with coronary artery bypass grafting. There are few reports of mitral valve surgery being performed successfully for papillary muscle rupture due to coronary artery disease in the chronic stage.
