Repair of delayed left ventricular rupture after mitral valve replacement: report of a case.
Rupture of the left ventricle (LV) after mitral valve replacement (MVR) is a devastating complication, associated with high mortality. A 64-year-old woman with a type I delayed LV rupture, which occurred after MVR with a 27-mm St. Jude Medical mitral prosthesis for mitral stenosis, was successfully treated by a combination of intracardiac and extracardiac surgical repair techniques. The extracardiac repair involved approximating the edges of myocardium around the tear with large sutures bolstered by strips of Teflon felt, then covering the epicardial hematoma with another porcine pericardial patch, using gelatin resorcinol formaldehyde glue and collagen sheets. The intracardiac repair involved suturing the edges of an oval piece of porcine pericardium to the endocardium around the laceration. No LV pseudoaneurysm was detected postoperatively on echocardiography or computed tomography scans. The patient is well 2 years after the operation.
Terada
Hitoshi
H
First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, 431-3192, Hamamatsu, Japan.
Kazui
Teruhisa
T
Yamashita
Katsushi
K
Washiyama
Naoki
N
Suzuki
Takayasu
T
Suzuki
Kazuchika
K
Ohkura
Kazuhiro
K
Hasan Muhammad
Bashar Abul
BA
D001705:Bioprosthesis / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006341:Heart Rupture / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation; D018570:Risk Assessment; D013524:Surgical Flaps; D013997:Time Factors; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome
D014014:Tissue Adhesives