title: [A case of emergency surgery for acute mitral regurgitation due to complete papillary muscle rupture as complication of acute inferior myocardial infarction].
abstract: We experienced a case with acute mitral regurgitation caused by complete posterior papillary muscle rupture as complication of acute inferior myocardial infarction, who underwent successfully emergency operation of mital valve replacement and coronary revascularization in acute stage. A 64-year-old woman developed sudden cardiogenic shock shortly after the onset of acute inferior myocardial infarction. The diagnosis of acute inferior myocardial infarction was based on the electrocardiographic findings. Under IABP support, preoperative coronary angiography visualized total occlusion of segment 3 of the right coronary artery, and preoperative left ventriculography showed akinesis of inferior wall and severe mitral regurgitation. At 6 hours after onset of papillary muscle rupture, emergency operation was performed. At operation, posterior papillary muscle was found to be totally ruptured. Coronary artery revascularization and mitral valve replacement were performed. Postoperative course was uneventful, with 4 days of IABP and 5 days of ventilatory support. She was discharged on the twentieth postoperative day in NYHA class I. Reports of successful emergency operation for total papillary muscle rupture following acute myocardial infarction are rare. Early diagnosis and surgical treatment are mandatory to save this group of patients.
authors.affiliation: First Department of Surgery, Yokohama City University School of Medicine, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yanagi
authors.forename: J
authors.initials: J
authors.lastname: Kondo
authors.forename: K
authors.initials: K
authors.lastname: Uchida
authors.forename: M
authors.initials: M
authors.lastname: Tobe
authors.forename: S
authors.initials: S
authors.lastname: Suzuki
authors.forename: Y
authors.initials: Y
authors.lastname: Yano
mesh_terms: D004630:Emergencies; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000150:complications* / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology* / Q000601:surgery*; D009203:Myocardial Infarction / Q000601:surgery; D009204:Myocardial Revascularization; D010210:Papillary Muscles