Left ventricular rupture after mitral valve replacement. Report of two cases and a review of the literature.
Rupture of the left ventricle following mitral valve replacement occurred in 2 women among 520 patients (0.4%) during a 17-year-period at the Beilinson Medical Centre. In one patient, a delayed, type II rupture, followed by immediate exanguination, resulted from a 31 mm cloth-covered Starr-Edwards prosthesis inserted in a normal sized left ventricle. In the second patient, an intra-operative type I rupture occurred as a result of an over-zealous resection of a heavily calcified valve and annulus. Repeated attempts at surgical repair were unsuccessful. A review of 46 previously reported cases revealed several other factors that might be responsible for this complication which carries a 40-100% mortality rte, depending on whether it is diagnosed intra-operatively or in the immediate postoperative period. These factors and the variety of surgical approaches used for the repair of this grave complication are discussed.
D000328:Adult; D005260:Female; D006341:Heart Rupture / Q000209:etiology*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006352:Heart Ventricles / Q000293:injuries*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications