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Updated: Jul 19, 2026
Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
[Case of papillary muscle rupture diagnosed by preoperative transesophageal echocardiography]
Yoshinobu Kimura1, Masayasu Nakayama, Yasuhiro Kamada
1Department of Anesthesiology, Nikko Memorial Hospital, Muroran 051-8501.
Abstract:
A 46-year-old man with severe mitral regurgitation (MR) was scheduled for emergency surgery for chordae tendae repairment. Preoperative transesophageal echocardiography (TEE) revealed massive MR due to a rupture in the antero-lateral papillary muscle. We changed the operation procedure to mitral valve replacement. It is difficult to diagnose papillary muscle rupture. Therefore, we should perform TEE on the patient with acute MR of unknown origin.
Insights
Diagnosing papillary muscle rupture causing severe mitral regurgitation (MR) is challenging. Transesophageal echocardiography (TEE) is crucial for identifying acute MR of unknown origin.
Area of Science:
- Cardiology
- Cardiac Surgery
- Diagnostic Imaging
Background:
- Severe mitral regurgitation (MR) necessitates timely intervention.
- Papillary muscle rupture is a rare but critical complication leading to acute MR.
- Prompt diagnosis is essential for appropriate surgical management.
Observation:
- A 46-year-old male presented with severe MR requiring emergency surgery.
- Preoperative transesophageal echocardiography (TEE) identified a ruptured anterolateral papillary muscle as the cause of massive MR.
- The planned chordae tendineae repair was changed to mitral valve replacement.
Findings:
- Transesophageal echocardiography (TEE) is highly effective in diagnosing papillary muscle rupture.
- Papillary muscle rupture presents a diagnostic challenge in acute mitral regurgitation.
- Accurate preoperative imaging is vital for surgical planning in complex MR cases.
Implications:
- TEE should be considered in all patients with acute mitral regurgitation of unknown etiology.
- Early diagnosis of papillary muscle rupture can guide surgical strategy, improving patient outcomes.
- This case highlights the importance of advanced echocardiography in managing life-threatening cardiac conditions.
