Clinical outcome after mitral valve surgery due to ischemic papillary muscle rupture

Thomas Schroeter, Sven Lehmann, Martin Misfeld, Michael Borger, Sreekumar - Subramanian, Friedrich W. Mohr, Farhad Bakthiary

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Severe mitral regurgitation secondary to papillary muscle rupture is an infrequent but catastrophic complication after myocardial infarction. Without surgical treatment, mortality can reach 80%, but surgical treatment also carries substantial perioperative morbidity and mortality. Methods: We retrospectively analyzed 28 patients who underwent mitral valve surgery for ischemic papillary muscle rupture. Results: The 30-day mortality rate was 39.3% (11 of 28). There were no significant differences in the baseline characteristics, and concomitant coronary artery bypass (CABG) was performed in 66.7% of the survivor group and in 61.5% of the nonsurvivor group (p = 0.245). Mortality predictors included low cardiac output (p = 0.05), renal failure (p = 0.005), and implementation of extracorporeal membrane oxygenation therapy (p = 0.005). The time between myocardial infarction and surgery showed no significant effects on survival. Conclusions: Papillary muscle rupture with severe mitral regurgitation carries a high operative mortality. Additional CABG does not influence the acute postoperative course. Postoperative development of low cardiac output with a need for extracorporeal membrane oxygenation therapy and renal failure with hemodialysis substantially reduces survival.

Original languageEnglish (US)
Pages (from-to)820-824
Number of pages5
JournalAnnals of Thoracic Surgery
Volume95
Issue number3
DOIs
StatePublished - Mar 2013
Externally publishedYes

Fingerprint

Papillary Muscles
Mitral Valve
Rupture
Mortality
Low Cardiac Output
Extracorporeal Membrane Oxygenation
Mitral Valve Insufficiency
Renal Insufficiency
Myocardial Infarction
Survival
Therapeutics
Coronary Artery Bypass
Survivors
Renal Dialysis
Morbidity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Clinical outcome after mitral valve surgery due to ischemic papillary muscle rupture. / Schroeter, Thomas; Lehmann, Sven; Misfeld, Martin; Borger, Michael; Subramanian, Sreekumar -; Mohr, Friedrich W.; Bakthiary, Farhad.

In: Annals of Thoracic Surgery, Vol. 95, No. 3, 03.2013, p. 820-824.

Research output: Contribution to journalArticle

Schroeter, Thomas ; Lehmann, Sven ; Misfeld, Martin ; Borger, Michael ; Subramanian, Sreekumar - ; Mohr, Friedrich W. ; Bakthiary, Farhad. / Clinical outcome after mitral valve surgery due to ischemic papillary muscle rupture. In: Annals of Thoracic Surgery. 2013 ; Vol. 95, No. 3. pp. 820-824.
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AU - Mohr, Friedrich W.

AU - Bakthiary, Farhad

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