title: Papillary muscle rupture after myocardial infarction during left ventricular assist device support.
abstract: We report a rare case of papillary muscle rupture due to myocardial infarction during left ventricular assist device support. A 69-year-old woman with cardiogenic shock due to acute myocardial infarction requiring venoarterial extracorporeal membrane oxygenation support was transferred for further surgical intervention. Six days after the event, extracorporeal membrane oxygenation was decannulated, and an extracorporeal left ventricular assist device was implanted. On postoperative day 11, she suffered from sudden onset hypoxia due to pulmonary edema. Transesophageal echocardiography showed new onset severe mitral regurgitation. No further surgical intervention was performed according to the family's wishes, and she passed away on the 22nd postoperative day. Autopsy findings revealed papillary muscle rupture. Although the left ventricle is unloaded by the left ventricular assist device, papillary muscle rupture should be recognized as a possible complication after myocardial infarction.
authors.affiliation: Department of Cardiac Surgery, Asahikawa Medical University Hospital, Hokkaido, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Kunioka
authors.affiliation: Department of Cardiac Surgery, Asahikawa Medical University Hospital, Hokkaido, Japan. kthrhrt11@gmail.com.|Section of Cardiac and Thoracic Surgery, Department of Surgery, The University of Chicago, 5841 S Maryland Ave, E500, MC5040, Chicago, IL, 60637, USA. kthrhrt11@gmail.com.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kitahara
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University Hospital, Hokkaido, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kanda
authors.affiliation: Department of Cardiac Surgery, Asahikawa Medical University Hospital, Hokkaido, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Takeda
authors.affiliation: Department of Cardiac Surgery, Asahikawa Medical University Hospital, Hokkaido, Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Yoshida
authors.affiliation: Department of Cardiac Surgery, Asahikawa Medical University Hospital, Hokkaido, Japan.
authors.forename: Natsuya
authors.initials: N
authors.lastname: Ishikawa
authors.affiliation: Department of Cardiac Surgery, Asahikawa Medical University Hospital, Hokkaido, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kamiya
mesh_terms: D000368:Aged; D017548:Echocardiography, Transesophageal; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000175:diagnosis* / Q000601:surgery; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D010210:Papillary Muscles
keywords: Left ventricular assist device; Mitral regurgitation; Papillary muscle rupture