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An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat
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An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat

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Rupture of the posterior wall of the left ventricle after mitral valve replacement

Y V Tarichko1, N M Sankar

  • 1Department of Cardiovascular Surgery, National Research Centre of Surgery, Moscow, USSR.

The Journal of Cardiovascular Surgery
|March 1, 1991
PubMed

Insights

Mitral valve replacement can lead to left ventricular posterior wall rupture, a rare but serious complication. Prompt cardiopulmonary bypass and cardioplegic solution reinfusion are crucial for managing this event and improving patient survival.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Ventricular Mechanics

Background:

  • Mitral valve replacement is a common procedure to treat severe mitral valve disease.
  • Left ventricular posterior wall rupture is a rare but catastrophic complication following mitral valve replacement.
  • Understanding risk factors and management strategies is critical for improving patient outcomes.

Purpose of the Study:

  • To investigate the incidence and outcomes of left ventricular posterior wall rupture after mitral valve replacement.
  • To evaluate the effectiveness of cardiopulmonary bypass and specific repair techniques in managing this complication.

Main Methods:

  • Retrospective analysis of 1100 patients undergoing mitral valve replacement between 1970 and 1989.
  • Identification of patients who experienced left ventricular posterior wall rupture.
  • Review of management strategies, including cardiopulmonary bypass and surgical repair.

Main Results:

  • Seven patients (0.6%) experienced left ventricular posterior wall rupture.
  • Rupture occurred intraoperatively in four patients and postoperatively in three.
  • Cardiopulmonary bypass was initiated in six patients, enabling successful bleeding control and external repair.
  • Only one patient survived the complication.

Conclusions:

  • Left ventricular posterior wall rupture is a devastating complication of mitral valve replacement with a very low survival rate.
  • Successful management hinges on the rapid institution of cardiopulmonary bypass and reinfusion of cardioplegic solution.
  • External repair approach under cardiopulmonary bypass can control bleeding, but overall survival remains poor.

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