title: MitraClip implantation after acute ischemic papillary muscle rupture in a patient with prolonged cardiogenic shock.
abstract: Papillary muscle rupture is a rare but potentially lethal complication of acute myocardial infarction. We report a 77-year-old man who presented to the emergency department with dyspnea and nausea and acute onset of severe back pain 3 days earlier. Owing to rapid deterioration of his hemodynamic and respiratory situation, the patient was immediately transferred to the intensive care unit. Intubation and catecholamine support became necessary to stabilize hemodynamics. Echocardiography revealed severe mitral regurgitation due to a complete rupture of the posterior papillary muscle. Despite treatment extension to intraaortic balloon counterpulsation, the patient continued to be in cardiogenic shock. Because the patient was rejected for surgical intervention, he underwent successful emergency MitraClip (Abbott Vascular, Santa Clara, CA) implantation and was discharged from hospital in good clinical condition. This report suggests that MitraClip implantation is a safe and effective alternative treatment option in this devastating disorder.
authors: Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany. Electronic address: e.bahlmann@asklepios.com.
authors: Edda
authors: E
authors: Bahlmann
authors: Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany.
authors: Christian
authors: C
authors: Frerker
authors: Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany.
authors: Felix
authors: F
authors: Kreidel
authors: Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany.
authors: Thomas
authors: T
authors: Thielsen
authors: Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany.
authors: Alexander
authors: A
authors: Ghanem
authors: Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany.
authors: Hendrick
authors: H
authors: van der Schalk
authors: Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany.
authors: Hanno
authors: H
authors: Grahn
authors: Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany.
authors: Karl-Heinz
authors: KH
authors: Kuck
mesh_terms: D000208:Acute Disease; D000368:Aged; D006342:Heart Rupture, Post-Infarction / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D010210:Papillary Muscles; D019919:Prosthesis Implantation; D012770:Shock, Cardiogenic / Q000150:complications*; D013997:Time Factors