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Ruptured Papillary Muscles After Chordae-Preserving Bioprosthetic Mitral Valve Replacement

Matthew Fischer1, Ali Salehi1, Michael J Sopher1

  • 1Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.

The Annals of Thoracic Surgery
|August 26, 2017
PubMed

Insights

Perioperative bioprosthetic valve masses are rare. This case highlights ruptured papillary muscles discovered post-mitral valve replacement, emphasizing differential diagnosis and surgical management for this uncommon complication.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Pathology
  • Echocardiography

Background:

  • Bioprosthetic valve-associated masses are uncommon in the perioperative period.
  • Early detection and accurate diagnosis are crucial for patient outcomes.

Observation:

  • A 68-year-old male presented with perivalvular masses detected 7 days post-mitral valve replacement and coronary artery bypass grafting.
  • Transthoracic echocardiogram revealed the masses, with subsequent transesophageal echocardiogram identifying ruptured papillary muscles.

Findings:

  • The primary finding was the presence of perivalvular masses secondary to ruptured papillary muscles.
  • This rare complication occurred in the context of chordae-preserving mitral valve replacement.

Implications:

  • This case underscores the importance of considering papillary muscle rupture in the differential diagnosis of perioperative masses after mitral valve surgery.
  • Effective surgical management strategies are essential for addressing this rare but serious complication.

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