Surgical management of acute mitral valve regurgitation due to post-infarction papillary muscle rupture.

Details

Serval ID
serval:BIB_75E0B2D4CF36
Type
Article: article from journal or magazin.
Collection
Publications
Title
Surgical management of acute mitral valve regurgitation due to post-infarction papillary muscle rupture.
Journal
Journal of Heart Valve Disease
Author(s)
Tavakoli R., Weber A., Vogt P., Brunner H.P., Pretre R., Turina M.
ISSN
0966-8519 (Print)
ISSN-L
0966-8519
Publication state
Published
Issued date
2002
Peer-reviewed
Oui
Volume
11
Number
1
Pages
20-5
Language
english
Abstract
BACKGROUND AND AIM OF THE STUDY: Acute myocardial infarction associated with mitral papillary muscle rupture and cardiogenic shock carries a high mortality. Data relating to early and late survival after emergency mitral valve surgery and concomitant complete coronary artery revascularization in this patient population were analyzed.
METHODS: Between January 1988 and December 1998, 21 consecutive patients (mean age 62+/-9.7 years) underwent emergency coronary and concomitant mitral valve surgery for acute myocardial infarction and mitral papillary muscle rupture associated with cardiogenic shock. Mitral valve replacement was performed in 19 patients (90%), and mitral valve repair in two (10%). An average of 2.2 distal anastomoses per patient was performed. Revascularization was complete in 19 patients (90%). Preoperatively, intra-aortic balloon pumping was used in 11 patients (52%), and two (10%) had salvage surgery when arriving at the operating room under cardiopulmonary resuscitation. Early and late follow up was complete; mean follow up was 5+/-3 years (range: 16 months to 12 years).
RESULTS: Thirty-day mortality was 19% (4/21), with two cardiac-related early deaths (10%). Early morbidity included perioperative stroke in 6% (1/17), myocardial infarction in 6% (1/17), and need for hemodialysis in 18% (3/17). There were three late deaths; one was cardiac-related. Actuarial survival at one, five and 10 years was 81, 68 and 56%, respectively. All survivors were in NYHA class I or II.
CONCLUSION: Emergency surgery for acute post-infarction mitral papillary muscle rupture is justified, even as a salvage procedure. Concomitant mitral valve surgery and complete coronary artery revascularization achieve acceptable survival rates and satisfactory functional results.
Pubmed
Web of science
Create date
16/12/2014 19:15
Last modification date
20/08/2019 14:33
Usage data