Mitral valve repair in papillary muscle rupture

U.I. Hamid, R. Aksoy, P.S. Nia*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Papillary muscle rupture (PMR) is a significant mechanical complication following myocardial infarction (MI), a condition associated with a high mortality. It results in severe mitral valve regurgitation (MR), often accompanied by cardiogenic shock and pulmonary edema, requiring both emergent medical treatment and surgical intervention. Surgical treatment includes either chordal sparing mitral valve replacement or mitral valve repair, which is associated with a high mortality. Mitral valve repair is believed to be superior to mitral valve replacement with respect to improving left ventricular function, albeit with risk of repair failure and resulting in increased cross clamp times. Concomitant coronary revascularization may improve both short and long-term outcomes after surgery. With advances in medical innovations in the field of transcatheter devices, these devices may serve as a bridge to recovery or treatment in the setting of acute MR due to PMR. However, long-term data will be required to establish the non-inferiority of one treatment modality over the other. Management of these patients should be guided by a dedicated mitral heart team.
Original languageEnglish
Pages (from-to)281-289
Number of pages9
JournalAnnals of Cardiothoracic Surgery
Volume11
Issue number3
Early online date11 Mar 2022
DOIs
Publication statusPublished - May 2022

Keywords

  • Papillary muscle rupture (PMR)
  • myocardial infarction (MI)
  • mitral valve repair
  • mitral clip
  • neochordae
  • ACUTE MYOCARDIAL-INFARCTION
  • LONG-TERM SURVIVAL
  • POSTINFARCTION RUPTURE
  • CHORDAE TENDINEAE
  • REGURGITATION
  • SURGERY
  • REPLACEMENT
  • PROLAPSE

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