Surgical Treatment for Early Left Ventricular Rupture after Mitral Valve Replacement_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHU Yan , WANG Huishan , LI Xinmin , WANG Zengwei , JIN Yan , XIAO Yuehua.

Department of Cardiovascular Surgery， Cardiovascular Surgery Institute of PLA， General Hospital of Shenyang Military District， Shenyang 110016， P. R. China;

Corresponding author：

Keywords：

Mitral valve replacement; 　Left ventricular rupture; 　Early rupture; 　Surgical repair

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Abstract：　Objective　To investigate the cause, treatment， and prevention strategy of early left ventricular rupture after mitral valve replacement （MVR）.　Methods　We retrospectively analyzed clinical data of 7 patients who had early left ventricular rupture after MVR， among a total of 2 638 MVR patients， between May 1981 and November 2010 in General　Hospital of Shenyang Military District. There were 2 male patients and 5 female patients with their age ranging from 28 to 71 years old. One patient was New York Heart Association （NYHA） functional classⅡand 6 patients were NYHA functional classⅢ. Preoperative echocardiography showed that their left ventricular ejection fraction （LVEF） was 49%-60%　and their left ventricular end diastolic volume （LVEDV） was 29-42 ml. All the patients underwent prothetic valve　replacement under moderate hypothermia， general anesthesia and extracorporeal circulation.　Results　All the 7
patients underwent surgical repair for their early left ventricular rupture. There were 2 patients with TypeⅠ， 4 patients with TypeⅡ， and 1 patient with TypeⅢleft ventricular rupture. Four patients died of hemorrhagic shock or low cardiac output　syndrome. Three patients were successfully healed and discharged from hospital 7-15 days after the operation. The 3　surviving patients were followed up for 4.5-18.0 years, and they all had good general condition and satisfactory quality of life. No late pseudo-aneurysm was found during follow-up.　Conclusions　Early left ventricular rupture is difficult to repair with a high mortality. Effective prevention strategy should be applied to avoid it as much as possible. Once left ventricular　rupture occurs during the surgery， extracorporeal circulation should be quickly established， and it’s possible to save　patients’ life by reliable intracardiac and epicardial repair according to patients’ individual condition.

Citation： ZHU Yan,WANG Huishan,LI Xinmin,WANG Zengwei,JIN Yan,XIAO Yuehua.. Surgical Treatment for Early Left Ventricular Rupture after Mitral Valve Replacement. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(6): 615-618. doi: Copy

1.	Argiriou M， Patris V， Lama N， et al. Off pump repair of left　ventricular rupture following mitral valve replacement：The crucial assistance of the IntraAortic Balloon Pump. Int J Surg Case Rep， 2012， 4 （1）：5-6.
2.	Roberts WC， Morrow AG. Causes of early postoperative death　following cardiac valve replacement. Clinico-pathologic correlations in 64 patients studied at necropsy. J Thorac Cardiovasc Surg， 1967， 54 （3）：422-437.
3.	Karlson KJ， Ashraf MM， Robert LB. Rupture of left ventricle　following mitral valve replacement. Ann Thorac Surg， 1988， 46 （5）：590-597.
4.	Matteucci ML， Rescigno G， Capestro F， et al. Delayed left ventricle　posterior wall rupture following mitral replacement detected by　multislice CT-scan. J Card Surg， 2011， 26 （4）：383-384.
5.	Treasure RL， Rainer WG， Strevey TE， et al. Intraoperative left ventricular rupture associated with mitral valve replacement. Chest， 1974， 66 （5）：511-514.
6.	Robicsek F. Left ventricular rupture after mitral valve replacement：risk factor analysis and outcome of resuscitation. J Heart Valve Dis， 2009， 18 （3）：352.
7.	Kurazumi H， Mikamo A， Suzuki R， et al. Mitral-valve replacement for a severely calcified mitral annulus：a simple and novel technique. Eur J Cardiothorac Surg， 2011， 39 （3）：407-409.
8.	Kamada M， Ohsaka K， NAGAMINE Susumu， et al. Left ventricular rupture following mitral valve replacement due to oversize prosthesis. Jpn J Thorac Cardiovasc Surg， 2004， 52 （12）：589-591.
9.	Deniz H， Sokullu O， Sanioglu S， et al. Risk factors for posterior ventricular rupture after mitral valve replacement：results of 2560 patients. Eur J Cardiothorac Surg， 2008， 34 （4）：780-784.
10.	Hosono M， Shibata T， Sasaki Y， et al. Left ventricular rupture after mitral valve replacement：risk factor analysis and outcome of resuscitation. J Heart Valve Dis， 2008， 17 （1）：42-47.
11.	Sersar SI， Jamjoom AA. Left ventricular rupture post mitral valve replacement. Clin Med Cardiol， 2009， 3 （3）：101-113.
12.	Cheikhaoui Y， Amahzoune B， Oukerraj L， et al. Ruptures of the posterior wall of the left ventricle after mitral valve replacement：　surgical repair and prevention. Ann Cardiol Angeiol （Paris）， 2001， 50 （3）：146-150.
13.	Digonnet A， Flecher E， Aubert S， et al. Successful repair of late left ventricular rupture after mitral valve replacement. J Heart Valve Dis， 2007， 16 （2）：136-138.
14.	Fasol R， Wild T， El Dsoki S. Left ventricular rupture after mitral surgery：repair by patch and sealing. Ann Thorac Surg， 2004， 77 （3）：1070-1072.
15.	DE LA FUENTE A， Agudo O， Sánchez R， et al. Repair of left　ventricular rupture after mitral valve replacement：use of a Teflon patch and glue. Ann Thorac Surg， 1999， 67 （6）：1802-1803.
16.	Masroor S， Schor J， Carrillo R， et al. Endoventricular pocket repair of type I myocardial rupture after mitral valve replacement：a new technique using pericardial patch， Teflon felt， and BioGlue. Ann Thorac Surg， 2004， 77 （4）：1439-1441.
17.	Abid Q， Rao PS， Kendall SW. Use of intraaortic balloon pump in left ventricle rupture after mitral valve replacement. Ann Thorac Surg， 2002， 74 （6）：2194-2195.

1. 　Argiriou M， Patris V， Lama N， et al. Off pump repair of left　ventricular rupture following mitral valve replacement：The crucial assistance of the IntraAortic Balloon Pump. Int J Surg Case Rep， 2012， 4 （1）：5-6.
2. 　Roberts WC， Morrow AG. Causes of early postoperative death　following cardiac valve replacement. Clinico-pathologic correlations in 64 patients studied at necropsy. J Thorac Cardiovasc Surg， 1967， 54 （3）：422-437.
3. 　Karlson KJ， Ashraf MM， Robert LB. Rupture of left ventricle　following mitral valve replacement. Ann Thorac Surg， 1988， 46 （5）：590-597.
4. 　Matteucci ML， Rescigno G， Capestro F， et al. Delayed left ventricle　posterior wall rupture following mitral replacement detected by　multislice CT-scan. J Card Surg， 2011， 26 （4）：383-384.
5. 　Treasure RL， Rainer WG， Strevey TE， et al. Intraoperative left ventricular rupture associated with mitral valve replacement. Chest， 1974， 66 （5）：511-514.
6. 　Robicsek F. Left ventricular rupture after mitral valve replacement：risk factor analysis and outcome of resuscitation. J Heart Valve Dis， 2009， 18 （3）：352.
7. 　Kurazumi H， Mikamo A， Suzuki R， et al. Mitral-valve replacement for a severely calcified mitral annulus：a simple and novel technique. Eur J Cardiothorac Surg， 2011， 39 （3）：407-409.
8. 　Kamada M， Ohsaka K， NAGAMINE Susumu， et al. Left ventricular rupture following mitral valve replacement due to oversize prosthesis. Jpn J Thorac Cardiovasc Surg， 2004， 52 （12）：589-591.
9. 　Deniz H， Sokullu O， Sanioglu S， et al. Risk factors for posterior ventricular rupture after mitral valve replacement：results of 2560 patients. Eur J Cardiothorac Surg， 2008， 34 （4）：780-784.
10. 　Hosono M， Shibata T， Sasaki Y， et al. Left ventricular rupture after mitral valve replacement：risk factor analysis and outcome of resuscitation. J Heart Valve Dis， 2008， 17 （1）：42-47.
11. 　Sersar SI， Jamjoom AA. Left ventricular rupture post mitral valve replacement. Clin Med Cardiol， 2009， 3 （3）：101-113.
12. 　Cheikhaoui Y， Amahzoune B， Oukerraj L， et al. Ruptures of the posterior wall of the left ventricle after mitral valve replacement：　surgical repair and prevention. Ann Cardiol Angeiol （Paris）， 2001， 50 （3）：146-150.
13. 　Digonnet A， Flecher E， Aubert S， et al. Successful repair of late left ventricular rupture after mitral valve replacement. J Heart Valve Dis， 2007， 16 （2）：136-138.
14. 　Fasol R， Wild T， El Dsoki S. Left ventricular rupture after mitral surgery：repair by patch and sealing. Ann Thorac Surg， 2004， 77 （3）：1070-1072.
15. 　DE LA FUENTE A， Agudo O， Sánchez R， et al. Repair of left　ventricular rupture after mitral valve replacement：use of a Teflon patch and glue. Ann Thorac Surg， 1999， 67 （6）：1802-1803.
16. 　Masroor S， Schor J， Carrillo R， et al. Endoventricular pocket repair of type I myocardial rupture after mitral valve replacement：a new technique using pericardial patch， Teflon felt， and BioGlue. Ann Thorac Surg， 2004， 77 （4）：1439-1441.
17. 　Abid Q， Rao PS， Kendall SW. Use of intraaortic balloon pump in left ventricle rupture after mitral valve replacement. Ann Thorac Surg， 2002， 74 （6）：2194-2195.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Surgical Treatment for Early Left Ventricular Rupture after Mitral Valve Replacement

Abstract Full text Figures/Tables Video References Cited by

Format

Content