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Updated: Feb 19, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Circumflex Coronary Artery Lesion and Consequent Papillary Muscle Rupture after Chordal Sparing Mitral Valve
João Pedro Monteiro1, Diogo Rijo1, Sara Simões Costa1
1Serviço de Cirurgia Cardiotorácica, Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal.
Abstract:
Ischemic iatrogenic lesions can complicate surgical procedures on the mitral valve. One of the causative mechanisms is direct injury to or distortion of structures that lie in close proximity to the valve, such as the circumflex coronary artery. We report a case of iatrogenic circumflex coronary artery lesion after mitral replacement causing muscle wall dyskinesia, wall aneurism and papillary muscle rupture. We emphasize the role of post-operative echocardiography in the diagnosis of such complications by demonstrating a 25mm flail of a ruptured papillary muscle remaining sutured to the ring of the mitral prosthesis and moving freely inside the left ventricle intruding the aortic valve during systole.
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