title: Clinical Implications of Preserving Subvalvular Apparatus During Mitral Valve Replacement for Acute Ischemic Papillary Muscle Rupture.
abstract: We report the case of a patient who presented with sequential rupture of two papillary muscle bellies after emergent mitral valve replacement with subvalvular apparatus preservation for acute severe mitral regurgitation and cardiogenic shock during acute myocardial infarction. We discuss the possibility that the remaining chordae may have meanwhile contributed to muscle avulsion by exerting traction on ischemic myocardium and prevented embolization of the secondarily detached papillary muscle heads.
authors.affiliation: Department of Surgery, Hôpital Universitaire Saint Pierre, Université Libre de Bruxelles, Brussels, Belgium. Electronic address: didier_decanniere@stpierre-bru.be.
authors.forename: Didier
authors.initials: D
authors.lastname: de Cannière
authors.affiliation: Department of Cardiology, Hôpital Universitaire Saint Pierre, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Vandenbossche
authors.affiliation: Department of Cardiology, Hôpital Universitaire Saint Pierre, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Elias
authors.initials: E
authors.lastname: Nouar
authors.affiliation: Department of Surgery, Hôpital Universitaire Saint Pierre, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Faict
authors.affiliation: Department of Surgery, Hôpital Universitaire Saint Pierre, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Falchetti
authors.affiliation: Department of Cardiology, Hôpital Universitaire Saint Pierre, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Unger
mesh_terms: D000208:Acute Disease; D000792:Angiography; D004452:Echocardiography; D004562:Electrocardiography; D006342:Heart Rupture, Post-Infarction / Q000175:diagnosis / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D010210:Papillary Muscles / Q000000981:diagnostic imaging / Q000601:surgery*