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1 Chief, Cardiothoracic Surgery Service, Brooke Army Medical Center, Fort Sam Houston, Texas
2 Cardiothoracic Surgery Service, Brooke Army Medical Center, Fort Sam Houston, Texas, Fitzsimons Army Medical Center, Denver, and Section of Thoracic and Cardiovascular Surgery, St. Josephs Hospital, Denver
3 Chief, Cardiothoracic Surgery Service, Fitzsimons Army Medical Center, Denver, Colorado
We studied the case histories of seven patients with left ventricular rupture during mitral valve replacement in order to define the etiology, clarify the diagnosis and suggest better methods of prevention and management. Two types of perforation were identified: Type 1 is a tear of the thin attachment of the atrium to the ventricle in the posterior atrioventricular sulcus. Type 2 is in the midportion of the left ventricle overlying the papillary muscles. Prevention of this potentially lethal complication is emphasized by avoiding common etiologic agents. Early diagnosis, rapid reinstitution of bypass and accurate repair are essential maneuvers for a successful outcome.
Submitted on December 26, 1973
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