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 journalArticlepeer-review

24 Scopus citations

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 1 2013

ASJC Scopus subject areas

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

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