title: Papillary muscle rupture: an unusual complication of chordal sparing mitral valve replacement.
abstract: An adult patient with advanced rheumatic heart disease undergoing chordal sparing mitral valve replacement as well as aortic valve replacement is presented. The patient developed an unusual complication of an infarction of the retained head of the anterolateral papillary muscle with subsequent spontaneous rupture 72-hours postoperatively. The ruptured head of the papillary muscle was successfully resected via an aortotomy through the aortic valve prosthesis. The patient made an uneventful recovery. Care to avoid excessive tension on the preserved chordae during mitral valve replacement, especially in the setting of chronic rheumatic carditis, is stressed.
authors.affiliation: Department of Cardiothoracic Surgery, Faculty of Health Sciences, Free State University, Bloemfontein, South Africa.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Long
authors.forename: M
authors.initials: M
authors.lastname: Med
mesh_terms: D001021:Aortic Valve / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery; D009202:Cardiomyopathies; D002815:Chordae Tendineae / Q000473:pathology / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000209:etiology / Q000601:surgery; D010210:Papillary Muscles; D011183:Postoperative Complications; D012214:Rheumatic Heart Disease; D012422:Rupture, Spontaneous; D018487:Ventricular Dysfunction, Left / Q000209:etiology