title: Double valve replacement for acute spontaneous left chordal rupture secondary to chronic aortic incompetence.
abstract: A 54 years old male with undiagnosed chronic calcific degenerative aortic valve incompetence presented with acute left anterior chordae tendinae rupture resulting in severe left heart failure and cardiogenic shock. He was successfully treated with emergency double valve replacement using mechanical valves. The pathogenesis of acute rupture of the anterior chordae tendinae, without any evidence of infective endocarditis or ischemic heart disease seems to have been attrition of the subvalvular mitral apparatus by the chronic regurgitant jet of aortic incompetence with chronic volume overload. We review the literature with specific focus on the occurrence of this unusual event.
authors.affiliation: Department of Cardiothoracic surgery, Yorkshire Heart Centre, Leeds General Infirmary, Leeds, UK. sanjaykr33@hotmail.com
authors.forename: Sandeep
authors.initials: S
authors.lastname: Agarwala
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kumar
authors.forename: John
authors.initials: J
authors.lastname: Berridge
authors.forename: Jim
authors.initials: J
authors.lastname: McLenachan
authors.forename: David J
authors.initials: DJ
authors.lastname: O'Regan
mesh_terms: D000208:Acute Disease; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000150:complications* / Q000601:surgery*; D002815:Chordae Tendineae; D006349:Heart Valve Diseases / Q000209:etiology / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D012422:Rupture, Spontaneous