title: Patch detachment after mitral valve repair with posterior leaflet augmentation: a case report.
abstract: Mitral valve (MV) repair is indicated for patients with severe MR. We report a case of acute MR caused by patch detachment after posterior leaflet augmentation in MV repair. A 65-year-old male underwent MV repair with posterior leaflet augmentation and coronary artery bypass graft 1 month prior to this study. An inverted T-shaped incision was made on the posterior mitral leaflet (PML), and a piece of autologous fresh pericardium was sewn in the PML defect. Seven days after hospital discharge, he started feeling chest pain and presented with pulseless electrical activity. Ultrasonic cardiography showed severe mitral regurgitation (MR), which was suggestive of acute MR. We performed emergency reoperation. The edge of the autologous pericardial patch was detached from the anterior papillary muscle, and MV replacement was performed. He was discharged from the hospital 55 days after the reoperation and returned to his normal daily life. We conclude that avoidance of tension focalization during MV repair may be important.
authors.affiliation: Department of Cardiovascular Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan. gomit@shinshu-u.ac.jp.
authors.forename: Toshihito
authors.initials: T
authors.lastname: Gomibuchi
authors.affiliation: Department of Cardiovascular Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan. ttakano-ths@umin.ac.jp.
authors.forename: Tamaki
authors.initials: T
authors.lastname: Takano
authors.affiliation: Department of Cardiovascular Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan. aruko@shinshu-u.ac.jp.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Wada
authors.affiliation: Department of Cardiovascular Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan. mayflyt@shinshu-u.ac.jp.
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Terasaki
authors.affiliation: Department of Cardiovascular Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan. seto@shinshu-u.ac.jp.
authors.forename: Tatsuichiro
authors.initials: T
authors.lastname: Seto
authors.affiliation: Department of Cardiovascular Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan. dfukui@shinshu-u.ac.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fukui
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D010496:Pericardium / Q000637:transplantation; D012086:Reoperation; D017211:Treatment Failure; D016896:Treatment Outcome