Browse > Article

Epicardial Repair of Acute Atrioventricular Groove Disruption Complicating Mitral Valve Replacement - A case report -  

Cho, Kwang-Ree (Department of Thoracic and Cardiovascular Surgery, Halla General Hospital)
Kang, Jae-Geul (Department of Thoracic and Cardiovascular Surgery, Halla General Hospital)
Jin, Sung-Hoon (Department of Thoracic and Cardiovascular Surgery, Halla General Hospital)
Publication Information
Journal of Chest Surgery / v.40, no.12, 2007 , pp. 855-858 More about this Journal
Abstract
A left ventricular rupture might be one of the most disastrous complications after a mitral valve replacement. An acute atrioventricular groove rupture (type I) was detected in a 54-year-old female diagnosed with a mitral stenosis combined with severe tricuspid regurgitation. She had a prior medical history of an open mitral commissurotomy in Japan at 30 years ago. The surgical findings suggested that the previous procedure was not a simple commissurotomy but a commissurotomy combined with a posteromedial annuloplasty procedure. After a successful mitral valve replacement and a measured (De Vega type) tricuspid annuloplasty, the weaning from a cardiopulmonary bypass was uneventful. However, copious intraoperative bleeding from the posterior wall was detected and the cardiopulmonary bypass was restarted. Exposure of the posterior wall of the left ventricle showed bleeding from the atrioventricular groove 3 cm lateral to the left atrial auricle. Under the impression of a Type I left ventricular rupture, epicardial repair (primary repair of the Teflon felt pledgetted suture, continuous sealing suture using auto-pericardial patch and application of fibrin-sealant) was attempted. Successful local control was made and the patient recovered uneventfully. The patient was discharged at 14 postoperative days without complications. We report this successful epicardial repair of an acute type I left ventricular rupture after mitral valve replacement.
Keywords
Ventricular rupture; Mitral valve, surgery; Rupture;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Karlson KJ, Ashraf MM, Berger RL. Rupture of left ventricle following mitral valve replacement. Ann Thorac Surg 1988;46:590-7   DOI   PUBMED   ScienceOn
2 Fasol R, Wild T, El Dsoki S. Left ventricular rupture after mitral surgery: repair by patch and sealing. Ann Thorac Surg 2004;77:1070-2   DOI   ScienceOn
3 Schuetz A, Schulze C, Wildhirt SM. Off-pump epicardial tissue sealing- a novel method for atrioventricular disruption complicating mitral valve procedures. Ann Thorac Surg 2004;78:569-74   DOI   ScienceOn
4 Kim BY, Hyr Y, Yoo BH, Lee JH, Yu HS, Cho DI. Left ventricular rupture complicated with mitral valve replacement. Korean J Thorac Cardiovasc Surg 1982;15: 250-3
5 Miller DW, Johnson DD, Ivey TD. Does preservation of the posterior chordae tendineae enhance survival during mitral valve replacement? Ann Thorac Surg 1979;28:22-7   DOI   PUBMED   ScienceOn
6 Treasure RL, Rainer WG, Strevey TE, SadlerTR. Intraoperative left ventricular rupture associated with mitral valve replacement. Chest 1974;66:511-4   DOI   ScienceOn
7 Masroor S, Schor J, Carrillo R, Williams DB. 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;77:1439-41   DOI   ScienceOn
8 Yaku H, Shimada Y, Yamada Y, et al. Partial translocation for repair of left ventricular rupture after mitral valve replacement. Ann Thorac Surg 2004;78:1851-3   DOI   PUBMED   ScienceOn