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Rupture of mitral valve chordae in hypertrophic cardiomyopathy

Florence Boissier1, Guy Achkouty1, Patrick Bruneval2

  • 1Department of Cardiology, hôpital Européen Georges Pompidou, Assistance publique-Hôpitaux de Paris, 75015 Paris, France.

Archives of Cardiovascular Diseases
|March 11, 2015
PubMed

Insights

Mitral valve chordal rupture is infrequent in hypertrophic cardiomyopathy, typically affecting older patients with obstructive disease. This condition often leads to severe mitral regurgitation requiring surgical intervention.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Pathology

Background:

  • Mitral valve chordal rupture is rarely reported in hypertrophic cardiomyopathy.
  • The prevalence and characteristics of this event in large cohorts remain uncharacterized.

Purpose of the Study:

  • To determine the prevalence of mitral valve chordal rupture in hypertrophic cardiomyopathy patients.
  • To describe the clinical, echocardiographic, surgical, and histological features of affected individuals.

Main Methods:

  • Retrospective review of patients with hypertrophic cardiomyopathy (2000-2010).
  • Identification of mitral valve chordal rupture via echocardiography.
  • Comparison with patients without chordal rupture.

Main Results:

  • Six of 580 hypertrophic cardiomyopathy patients (1%) had mitral valve chordal rupture.
  • Rupture involved the posterior mitral leaflet, often associated with systolic anterior motion and leaflet elongation.
  • Pre-existing left ventricular outflow tract obstruction resolved post-rupture in surgically treated patients.
  • Histology revealed myxomatous degeneration in all cases.

Conclusions:

  • Mitral valve chordal rupture is an infrequent complication in hypertrophic cardiomyopathy.
  • It primarily affects elderly patients with obstructive hypertrophic cardiomyopathy and posterior leaflet involvement.
  • Severe mitral regurgitation necessitating surgery is a common outcome, with myxomatous degeneration as a potential underlying factor.
Abstract

Keywords:
Cardiomyopathie hypertrophiqueChordal ruptureHypertrophic cardiomyopathyInsuffisance mitraleMitral regurgitationMitral valve repairPlastie mitraleRupture de cordage mitral

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