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Clinical outcome after mitral valve surgery due to ischemic papillary muscle rupture

Thomas Schroeter1, Sven Lehmann, Martin Misfeld

  • 1Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany. thomas-schroeter@gmx.de

The Annals of Thoracic Surgery
|December 11, 2012
PubMed
Abstract

Insights

Severe mitral regurgitation from papillary muscle rupture after heart attack has high mortality. Post-surgery complications like low cardiac output and renal failure significantly reduce survival rates.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Critical Care Medicine

Background:

  • Papillary muscle rupture causing severe mitral regurgitation is a rare but devastating myocardial infarction complication.
  • Untreated mortality approaches 80%, while surgical intervention carries significant risks.

Purpose of the Study:

  • To evaluate the outcomes of mitral valve surgery in patients with ischemic papillary muscle rupture.
  • To identify predictors of mortality in this high-risk patient group.

Main Methods:

  • Retrospective analysis of 28 patients undergoing mitral valve surgery for ischemic papillary muscle rupture.
  • Assessment of baseline characteristics, concomitant procedures, and postoperative outcomes.

Main Results:

  • 30-day mortality was 39.3% (11 of 28 patients).
  • Mortality predictors included low cardiac output, renal failure, and extracorporeal membrane oxygenation (ECMO) therapy.
  • Concomitant coronary artery bypass grafting (CABG) did not significantly impact survival.

Conclusions:

  • Papillary muscle rupture with severe mitral regurgitation has high operative mortality.
  • Postoperative low cardiac output, need for ECMO, and renal failure requiring hemodialysis are associated with reduced survival.
  • Additional CABG does not improve acute postoperative outcomes.

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