[Acute early mitral insufficiency following myocardial infarction]

Five cases of acute mitral incompetence complicating myocardial infarction at an early stage underwent early mitral valve replacement. The surgical indications were deterioration of the clinical and haemodynamic conditions or dependance on medical therapy and intra-aortic balloon pumping. The mitral lesion was haemorrhagic necrosis of the posterior papillary muscle in all cases, associated with rupture of the chordae or papillary muscle in 3 cases. The outcome was favourable in all cases and has been maintained after more than two years post operative follow-up. The problems of the surgical indications, the mitral valve replacement and coronary revascularisation are discussed.