Mitral Valve Plasty in Postinfarction Partial Rupture of a Posterior Papillary Muscle / 日本心臓血管外科学会雑誌

ABSTRACT

We report the successful treatment of an 81-year-old woman after a difficult diagnosis of mitral valve regurgitation resulting from partial rupture of the posterior papillary muscle. The patient, with a chief complaint of dyspnea, was admitted to our hospital in October, 2010. Echocardiography revealed severe MR and an oscillating abnormal mass attached to the mitral posterior leaflet was assessed as vegetation. Her general condition worsened and coronary angiography revealed 90% stenosis at #6 and 99% stenosis at #12. Partial papillary muscle rupture of post acute myocardial infarction was ruled out. Urgent surgery was performed. It is found that tissue we had assessed as vegetation was a part of the posterior papillary muscle with no signs of infection. MVP with quadrangular resection (P3), annuloplasty and CABG (LITA-LAD, SVG-OM) was performed. The patient was discharged on the 28th postoperative day. Echocardiography showed no MR for four years after the surgery.