title: Posterior midventricular rupture after mitral valve replacement.
abstract: Posterior midventricular rupture occurred in 3 patients after insertion of a mitral prosthesis. Iatrogenic surgical trauma was not implicated. There were five clinical factors common to each case: a woman with mitral stenosis; a left ventricle of relatively normal size; the use of intermitent cold cardioplegia; the insertion of a porcine heterograft valve; and transient postoperative hypertension. Rupture in such cases may be caused by hyperdynamic left ventricular contraction against the strut of the prosthesis. Causes of ventricular perforation are discussed.
mesh_terms: D001705:Bioprosthesis / Q000009:adverse effects*; D005260:Female; D006324:Heart Arrest, Induced; D006341:Heart Rupture / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D006973:Hypertension / Q000209:etiology; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000503:physiopathology / Q000601:surgery*; D009200:Myocardial Contraction; D011183:Postoperative Complications