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Patch detachment after mitral valve repair with posterior leaflet augmentation: a case report

Toshihito Gomibuchi1, Tamaki Takano2, Yuko Wada3

  • 1Department of Cardiovascular Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan. gomit@shinshu-u.ac.jp.

Journal of Cardiothoracic Surgery
|September 14, 2015
PubMed

Insights

Mitral valve repair complications can arise from patch detachment, leading to acute mitral regurgitation. Careful surgical technique is crucial to avoid tension and ensure repair integrity.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Valve Repair
  • Mitral Valve Disease

Background:

  • Severe mitral regurgitation (MR) often necessitates mitral valve (MV) repair.
  • Posterior leaflet augmentation is a technique used in MV repair.
  • Coronary artery bypass grafting (CABG) may be performed concurrently.

Observation:

  • A 65-year-old male developed acute MR with pulseless electrical activity one month post-MV repair with posterior leaflet augmentation and CABG.
  • Surgical findings revealed detachment of the autologous pericardial patch from the anterior papillary muscle.
  • The patient presented with chest pain and severe MR, indicating acute valve dysfunction.

Findings:

  • Patch detachment following posterior leaflet augmentation caused acute mitral regurgitation.
  • Emergency reoperation was required due to the complication.
  • Mitral valve replacement was ultimately performed.

Implications:

  • This case highlights the risk of patch dehiscence after mitral valve repair.
  • Avoiding tension focalization during posterior leaflet augmentation is critical for successful MV repair.
  • Careful surgical technique can prevent severe complications like acute MR and hemodynamic instability.

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