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Clinical Outcome After Mitral Valve Surgery Due to Ischemic Papillary Muscle Rupture.
MedLine Citation:
PMID:  23219255     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
Thomas Schroeter; Sven Lehmann; Martin Misfeld; Michael Borger; Sreekumar Subramanian; Friedrich W Mohr; Farhad Bakthiary
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-4
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  -     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany. Electronic address: thomas-schroeter@gmx.de.
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