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Postinfarction double papillary muscle rupture in three surgically excised mitral valves

Francesca V Lobo1, John Fernandes, H Alexander Heggtveit

  • 1Department of Anatomic Pathology, Hamilton Health Sciences, Hamilton General Site, Hamilton, Ontario, Canada. caprebru@hhsc.ca

Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology
|September 20, 2005
PubMed

Insights

This study reports on three patients who underwent mitral valve replacement due to acute myocardial infarction complications. It highlights the extreme rarity of double papillary muscle rupture, previously only seen during autopsies.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Pathology

Background:

  • Acute myocardial infarction can lead to severe cardiac complications.
  • Mitral insufficiency and cardiogenic shock are serious consequences of myocardial infarction.
  • Papillary muscle rupture is a rare but critical complication.

Observation:

  • Three patients (58-72 years) underwent mitral valve replacement for cardiogenic shock and severe mitral insufficiency post-myocardial infarction.
  • Surgical examination revealed partial rupture of both papillary muscles in all three cases.
  • This represents a double papillary muscle rupture, a condition previously documented only in autopsies.

Findings:

  • The study confirms double papillary muscle rupture in surgically excised mitral valves following myocardial infarction.
  • Microscopic and gross findings correlated to confirm the papillary muscle ruptures.
  • This is the first reported instance of surgically treated double papillary muscle rupture.

Implications:

  • Highlights the possibility of surgically treating double papillary muscle rupture.
  • Suggests a need for increased vigilance for this rare complication in myocardial infarction patients.
  • Contributes to understanding the pathological spectrum of myocardial infarction complications.

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