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An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat
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An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat

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Acute mitral valve regurgitation secondary to papillary muscle rupture due to infective endocarditis

Farshad Amirkhosravi1, Qasim Al Abri2, Alexander J Lu3

  • 1Department of General Surgery, Houston Methodist Hospital, Houston, TX, USA.

Journal of Cardiothoracic Surgery
|July 8, 2022
PubMed
Abstract

Insights

Papillary muscle rupture from infective endocarditis is rare. Early mitral valve surgery and prolonged antibiotics are key for patients with acute heart failure, especially those with prosthetic valves.

Area of Science:

  • Cardiology
  • Infective Endocarditis
  • Cardiac Surgery

Background:

  • Papillary muscle rupture due to infective endocarditis is a rare complication.
  • Management strategies for this condition are not well-described in medical literature.
  • This case report aims to elucidate treatment approaches based on current guidelines.

Observation:

  • A 58-year-old male presented with acute heart failure.
  • The patient experienced papillary muscle rupture, confirmed by pathology to be caused by infective endocarditis.
  • He underwent successful en bloc resection of the mitral valve and prosthetic valve replacement.

Findings:

  • Early mitral valve surgery is the primary treatment for papillary muscle rupture causing acute heart failure, irrespective of the underlying cause.
  • Prolonged, culture-guided antibiotic therapy is crucial, particularly for patients with prosthetic valves.
  • The patient recovered well post-operatively and remained in good health after discharge.

Implications:

  • Clinical presentation should guide treatment decisions in cases of papillary muscle rupture secondary to infective endocarditis.
  • Prompt surgical intervention combined with appropriate antibiotic management can lead to favorable outcomes.
  • This case highlights the importance of a multidisciplinary approach in managing complex cardiac conditions.
Keywords:
Case reportInfective endocarditisMitral regurgitationPapillary muscle rupture

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