PMID- 15384710
OWN - NLM
STAT- MEDLINE
DCOM- 20041014
LR  - 20181113
IS  - 1344-4964 (Print)
IS  - 1344-4964 (Linking)
VI  - 52
IP  - 8
DP  - 2004 Aug
TI  - Papillary muscle rupture following acute myocardial infarction.
PG  - 367-71
AB  - OBJECTIVES: Papillary muscle rupture following acute myocardial infarction (AMI), 
      which rarely occurs, leads to catastrophic outcomes. We reviewed 6 patients who 
      were diagnosed as having papillary muscle rupture. SUBJECTS AND METHODS: Between 
      February 1986 and September 2002, 6 consecutive patients underwent mitral valve 
      replacement (MVR) for acute mitral regurgitation due to postinfarction papillary 
      muscle rupture (4 men and 2 women, mean age 67 years). Preoperatively, all were 
      in New York Heart Association (NYHA) class IV. All patients had intraaortic 
      balloon pumping, and one needed additional percutaneous cardiopulmonary support. 
      Operations were performed within 1 to 19 days (mean 6.8) after the onset of AMI, 
      and within 24 hours after papillary muscle rupture. Complete ruptures were found 
      in 5 of 6 patients. Four patients had posterior papillary rupture and 2 patients 
      anterior. All patients underwent MVR to preserve the posterior mitral leaflet. 
      Concomitant coronary artery bypass grafting was performed in 5 of 6 patients 
      (mean 1.6 grafts per person) and pulmonary venous isolation for atrial 
      fibrillation in one patient. RESULTS: The cardiopulmonary bypass time ranged from 
      178 to 325 minutes (mean 236), and the aortic cross clamp time from 123 to 196 
      minutes (mean 155). Two patients died of low cardiac output syndrome. Of 4 
      operative survivors, 3 patients were in NYHA class I and one in class II. The 
      mean follow-up term was 21 months. One patient with the pulmonary venous 
      isolation has been in sinus rhythm. All survivors have been doing well without 
      any valve related complications. CONCLUSION: Six patients underwent MVR for the 
      papillary muscle rupture following AMI and the perioperative mortality rate was 
      33%. All survivors have been well with no cardiac events. We propose that in 
      papillary muscle rupture following AMI emergent surgery should be undertaken as 
      soon as possible, and that concomitant surgery should be performed as thoroughly 
      as possible.
FAU - Minami, Hiroya
AU  - Minami H
AD  - Department of Cardiovascular Surgery, Himeji Cardiovascular Center, Himeji, 
      Hyogo, Japan.
FAU - Mukohara, Nobuhiko
AU  - Mukohara N
FAU - Obo, Hidefumi
AU  - Obo H
FAU - Yoshida, Masato
AU  - Yoshida M
FAU - Nakagiri, Keitaro
AU  - Nakagiri K
FAU - Hanada, Tomoki
AU  - Hanada T
FAU - Maruo, Ayako
AU  - Maruo A
FAU - Matsuhisa, Hironori
AU  - Matsuhisa H
FAU - Morimoto, Naoto
AU  - Morimoto N
FAU - Shida, Tsutomu
AU  - Shida T
LA  - eng
PT  - Journal Article
PL  - Japan
TA  - Jpn J Thorac Cardiovasc Surg
JT  - The Japanese journal of thoracic and cardiovascular surgery : official 
      publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka 
      Gakkai zasshi
JID - 100884261
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Surgical Procedures/*methods
MH  - Cardiomyopathies/etiology/*surgery
MH  - Female
MH  - Heart Valve Prosthesis Implantation/methods
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/surgery
MH  - Mitral Valve Insufficiency/etiology/*surgery
MH  - Myocardial Infarction/*complications
MH  - *Papillary Muscles
MH  - Rupture, Spontaneous
MH  - Treatment Outcome
EDAT- 2004/09/24 05:00
MHDA- 2004/10/16 09:00
CRDT- 2004/09/24 05:00
PHST- 2004/09/24 05:00 [pubmed]
PHST- 2004/10/16 09:00 [medline]
PHST- 2004/09/24 05:00 [entrez]
AID - 10.1007/s11748-004-0012-4 [doi]
PST - ppublish
SO  - Jpn J Thorac Cardiovasc Surg. 2004 Aug;52(8):367-71. doi: 
      10.1007/s11748-004-0012-4.