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Delayed rupture of the left ventricle after mitral valve replacement with bioprosthesis
Abstract:
Rupture of the posterior ventricular wall after mitral valve replacement is a complication rarely reported in the literature. Perforation of the left ventricle after mitral valve replacement with a bioprosthesis has been described in only 3 patients. We have had 2 patients with this complication out of 322 patients who had mitral valve replacement with bioprosthesis. These perforations were caused by impingement of the posterior strut of the bioprosthesis on the posterior left ventricular wall, with intramyocardial hematoma and delayed rupture of the left ventricle.
Insights
Rarely, bioprosthetic mitral valve replacement can cause left ventricular rupture due to strut impingement. This study details two such cases, highlighting a rare but serious complication following this cardiac surgery.
Area of Science:
- Cardiovascular Surgery
- Cardiac Pathology
Background:
- Mitral valve replacement is a common cardiac procedure.
- Complications, though rare, require thorough investigation.
Observation:
- Two cases of posterior left ventricular wall rupture occurred after mitral valve replacement with a bioprosthesis.
- This complication has been described in only three other patients globally.
Findings:
- The ruptures were attributed to impingement of the bioprosthesis's posterior strut against the left ventricular wall.
- This impingement led to intramyocardial hematoma and subsequent delayed ventricular rupture.
Implications:
- Highlights a rare but critical complication of bioprosthetic mitral valve replacement.
- Suggests careful prosthesis selection and placement to avoid strut-related ventricular injury.
- Emphasizes the need for vigilance in diagnosing delayed ventricular rupture post-mitral valve surgery.