Total Posterior Papillary Muscle Rupture Associated with Acute Myocardial Infarction: A Case Report with Successful Emergency Surgery and a Review of Japanese Literatures.
10.4326/jjcvs.32.98
- VernacularTitle:緊急手術により救命しえた心筋梗塞後僧帽弁乳頭筋完全断裂の１例 過去１０年間の本邦報告例を含めて
- Author:
Masanori Sakaguchi
;
Shigehumi Suehiro
;
Toshihiko Shibata
;
Kohji Hattori
;
Hidekazu Hirai
;
Hiromichi Fujii
;
Takanobu Aoyama
;
Takeshi Ikuta
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2003;32(2):98-101
- CountryJapan
- Language:Japanese
-
Abstract:
A 64-year-old man was transferred to our hospital because of acute heart failure associated with myocardial infarction. Echocardiography revealed severe mitral regurgitation due to total rupture of the posterior papillary muscle. Following the diagnosis of papillary muscle rupture, intraaortic balloon pumping support was started, and surgery was performed without coronary angiography because of cardiogenic shock and renal dysfunction. The posterior papillary muscle was completely ruptured, and the anterior leaflet of the mitral valve was severely prolapsed. Without resecting the posterior leaflet, mitral valve replacement was successfully performed using a St. Jude Medical® prosthetic valve. The postoperative course was uneventful except for ventricular tachyarrhythmia which occurred during the acute phase postoperatively. Postoperative coronary angiography demonstrated no significant coronary arterial stenosis. In a patient with cardiogenic shock due to papillary muscle rupture, immediate surgical intervention is recommended as soon as the diagnosis has been established by echocardiography.
