Related Experiment Video
Updated: May 13, 2026
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Mitral valve repair for post-myocardial infarction papillary muscle rupture
Wobbe Bouma1, Inez J Wijdh-den Hamer, Theo J Klinkenberg
1Department of Cardiothoracic Surgery, University Medical Center Groningen, Groningen, Netherlands.
Objectives:
Papillary muscle rupture (PMR) is a rare, but serious mechanical complication of myocardial infarction (MI). Although mitral valve replacement is usually the preferred treatment for this condition, mitral valve repair may offer an improved outcome. In this study, we sought to determine the outcome of mitral valve repair for post-MI PMR and to provide a systematic review of the literature on this topic.
Methods:
Between January 1990 and December 2010, 9 consecutive patients (mean age 63.5 ± 14.2 years) underwent mitral valve repair for partial post-MI PMR. Clinical data, echocardiographic data, catheterization data and surgical reports were reviewed. Follow-up was obtained in December of 2012 and it was complete; the mean follow-up was 8.7 ± 6.1 (range 0.2-18.8 years).
Results:
Intraoperative and in-hospital mortality were 0%. Intraoperative repair failure rate was 11.1% (n = 1). Freedom from Grade 3+ or 4+ mitral regurgitation and from reoperation at 1, 5, 10 and 15 years was 87.5 ± 11.7%. Estimated 1-, 5-, 10- and 15-year survival rates were 100, 83.3 ± 15.2, 66.7 ± 19.2 and 44.4 ± 22.2%, respectively. There were 3 late deaths, and 2 were cardiac-related. All late survivors were in New York Heart Association Class I or II. No predictors of long-term survival could be identified.
Conclusions:
Mitral valve repair for partial or incomplete post-MI PMR is reliable and provides good short- and long-term results, provided established repair techniques are used and adjacent tissue is not friable. PMR type and adjacent tissue quality ultimately determine the feasibility and durability of repair.
Insights
Mitral valve repair for papillary muscle rupture after myocardial infarction is reliable, offering good short- and long-term outcomes. This approach is feasible when established techniques are used and tissue is not friable.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Papillary muscle rupture (PMR) is a rare but severe mechanical complication following myocardial infarction (MI).
- Mitral valve replacement is the standard treatment, but mitral valve repair may offer better outcomes.
Purpose of the Study:
- To assess the outcomes of mitral valve repair for post-MI PMR.
- To systematically review existing literature on mitral valve repair for post-MI PMR.
Main Methods:
- A review of 9 patients who underwent mitral valve repair for partial post-MI PMR between 1990 and 2010.
- Analysis of clinical, echocardiographic, catheterization, and surgical data with complete follow-up up to 18.8 years.
Main Results:
- 0% intraoperative and in-hospital mortality.
- 87.5% freedom from severe mitral regurgitation and reoperation at 15 years.
- Estimated 15-year survival rate of 44.4%, with late survivors in NYHA Class I or II.
Conclusions:
- Mitral valve repair is a reliable option for partial or incomplete post-MI PMR with good short- and long-term results.
- Feasibility and durability depend on PMR type and adjacent tissue quality.
- Established repair techniques are crucial for successful outcomes.
Related Concept Videos
01:26Mitral Stenosis III: Medical Management
01:22Mitral Valve Prolapse II: Assessment and Management
01:27Mitral Valve Prolapse I: Introduction
01:25Mitral Regurgitation III: Medical Management
01:20Mitral Regurgitation I: Introduction
01:19Mitral Valve Prolapse III: Nursing Management