Rupture of the Posterior Wall of the Left Ventricle after Mitral Valve Replacement: Etiological and Technical Considerations
| Autor: | Stuart C. Lennox, Mike Azariades |
|---|---|
| Rok vydání: | 1988 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Heart Ventricles medicine.medical_treatment Heart Rupture Prosthesis Postoperative Complications Posterior wall Mitral valve Internal medicine medicine Humans cardiovascular diseases Cardiac Surgical Procedures Papillary muscle Aged business.industry Mitral valve replacement Middle Aged Surgery medicine.anatomical_structure Ventricle cardiovascular system Cardiology Etiology Mitral Valve Female Cardiology and Cardiovascular Medicine business Complication |
| Zdroj: | The Annals of Thoracic Surgery. 46:491-494 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/s0003-4975(10)64682-6 |
| Popis: | Rupture of the posterior wall of the left ventricle after mitral valve replacement, although infrequent, may be a highly lethal complication. Controversy exists regarding the etiology of this complication. Suggested causative factors include the type and extent of the valvular disease, type and size of the prosthesis, and the surgical techniques used. Our experience over a 20-year period includes 10 patients with rupture of the left ventricle following mitral valve replacement. In all patients, both mitral leaflets were excised together with the attached chordae. Three patients survived after repair of the rupture. Repair consisted of compressing the area between the left atrium and the base of the papillary muscle using two strips of Teflon and deep mattress sutures passed beneath the coronary vessels in the atrioventricular groove. Since 1983 we have routinely preserved the posterior leaflet of the mitral valve with its attached chordae to maintain a "tethered loop" between the mitral valve and ventricle. No further ruptures have occurred. The technique used for repair represents reconstitution of the divided loop between the ventricle and the mitral valve. |
| Databáze: | OpenAIRE |
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