title: Surgical treatment of complete anterolateral papillary muscle rupture following acute myocardial infarction.
abstract: Papillary muscle rupture is a lethal complication of after acute myocardial infarction. We report the successful surgical management of complete anterolateral papillary muscle rupture associated with cardiogenic shock in an 80-year-old woman. The patient was admitted with the sudden onset of chest pain and dyspnea. After hemodynamics deteriorated rapidly, she was intubated and intra-aortic balloon pump was started immediately. Transthoracic echocardiography revealed severe mitral regurgitation due to complete anterolateral papillary muscle rupture associated with lateral myocardial infarction. Coronary angiography demonstrated complete occlusion of the first obtuse marginal artery. She underwent emergency mitral valve replacement and coronary artery bypass grafting. There were no complications of surgery and she was discharged on postoperative day 35. Rapid preoperative assessment and aggressive surgical management are important to improve the prognosis in this setting.
authors.affiliation: First Department of Surgery, University of Toyama, Toyama, Toyama, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Doi
authors.forename: Saori
authors.initials: S
authors.lastname: Nagura
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Fukahara
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshimura
mesh_terms: D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D054059:Coronary Occlusion / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D007442:Intubation, Intratracheal; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D010210:Papillary Muscles / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012720:Severity of Illness Index; D012770:Shock, Cardiogenic / Q000209:etiology; D016896:Treatment Outcome; D014463:Ultrasonography