[Left ventricular perforation after insertion of a mitral prosthesis. 6 cases].
The external ruptures of the left ventricule occuring in the first twelve postoperative hours and demonstrated by a disastrous haemorrhage or cardiac failure, the other traumatics accidents could be delayed and be observed during the first month, or even later. Essentially two mechanisms are implicated: -- Direct traumatism by a ball valve on the ventricular septrum. -- Sub-annular splitting in connection with the excision of a piece of calcareous valve. Two lines of approch can be offered to avoid these accidents: -- Choose a disc valve when the surgeon finds a small left ventricle below a stenosed and calcified mitral valve. -- Care in the decalcification of the mitral ring and the valvular resection, leaving in case of need a small calcified cuff for safety. The analysis of these findings clarify the main causes of left ventricular rupture after mitral replacement, rare complications, but ones which are very real.
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology; D005260:Female; D006335:Heart Injuries / Q000517:prevention & control; D006336:Heart Massage / Q000009:adverse effects; D006350:Heart Valve Prosthesis / Q000009:adverse effects* / Q000379:methods; D006352:Heart Ventricles / Q000293:injuries*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000601:surgery; D010490:Pericardial Effusion / Q000209:etiology; D012421:Rupture / Q000209:etiology; D012770:Shock, Cardiogenic / Q000209:etiology
Perforation ventriculaire gauche après mise en place d'une prothèse mitrale. Six observations