Document Detail


Use of a sandwich technique to repair a left ventricular rupture after mitral valve replacement.
MedLine Citation:
PMID:  24808783     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
One difficulty with external repair of left ventricular rupture after mitral valve replacement is collateral bleeding in friable myocardium adjacent to the rupture. The bleeding is caused by tension on the closing sutures, whether or not pledgets have been used. We report the case of a 69-year-old woman who underwent an uneventful mitral valve replacement. After cardiopulmonary bypass was terminated, brisk bleeding started from high in the posterior left ventricular wall, typical of a type III defect. We undertook external repair, placing a plug of Teflon felt into the cavity of the rupture and sandwiching it into place with pledgeted mattress and figure-of-8 sutures. The space occupied by the plug decreased the distance needed to obliterate the defect and thereby reduced the tension on the sutures necessary to achieve hemostasis. This simple technique enabled closure of the defect and avoided collateral tears that would have compromised an otherwise successful repair. Two years postoperatively, the patient had normal mitral valve function and no left ventricular aneurysm. In addition to reporting the patient's case, we review the types of left ventricular rupture that can occur during mitral valve replacement and discuss the various repair options.
Authors:
Myles E Lee; Mallika Tamboli; Anthony W Lee
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Publication Detail:
Type:  Journal Article     Date:  2014-04-01
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  41     ISSN:  1526-6702     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-05-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  195-7     Citation Subset:  IM    
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