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Date Published: 12/04/2022
Abstract Views: 273
Views PDF: 175
DOI: https://doi.org/10.47972/vjcts.v37i.755
Issue
Vol. 37
Section
Research Article
How to Cite
Dung, V. H. (2022). Clinical experience of surgical repair left ventricular rupture after mitral valve replacement . The Vietnam Journal of Cardiovascular and Thoracic Surgery, 37, 18-23. https://doi.org/10.47972/vjcts.v37i.755

Clinical experience of surgical repair left ventricular rupture after mitral valve replacement

Van Hung Dung

Main Article Content

Abstract

Background: Left ventricular rupture after mitral valve replacement is very rare but often leads to death. This study aimed to report one center experience.


Methods: Retrospective case series from 2001 to 2021 at the Heart Institute.


Results: There had 18 cases of left ventricular rupture after mitral valve replacement (0.2%). 94% of patients were female, the mean age at surgery was 57. Rheumatic mitral stenosis (11) or mitral disease (6) occurred in the majority of cases. 6/18 has posterior annulus calcification; 3/18 cases had reoperation after previous mitral valve replacement. The median valve size was 27 (25-29mm). Type I rupture 03; type II: 1 and type III: 14. Time of left ventricular rupture occurrence: early in 5; late in 2 and intermediate in 11 cases. The mortality rate was 61% (11/18). Regarding the repair technique, 8 cases of external repairs, without opening the heart and 10 cases of combined internal and external repairs, reinforced with bio-glue. 100% had supported by extracorporeal circulation and 15/18 cases had inserted intra-aortic balloon counterpulsation.


Conclusion: preserve the posterior valve as much as possible, gentle resection of the diseased valve, and no need for radical decalcification of the posterior annulus are measures to prevent left ventricular rupture. The combined technique of internal and external repairs with bio-glue coating has shown a good hemostatic and high success rate.

Article Details

Keywords

left ventricular rupture, mitral disease, rheumatic valvular disease, intra-aortic balloon counterpulsation

References

1. Roberts WC, Morrow AG. Cause of early postoperative death following cardiac valve re-placement. J Thorac Cardiovasc Surg 1967;54:422.
2. Treasure RL, Rainer WG, Streavey TE, Sadler TR. Intraoperative left ventricular rupture associated with mitral valve replacement. Chest 1974: 66:511
3. Zacharias A, Groves LK, Cheanvechai C, Effler DB. Rupture of the posterior wall of the left ventricle after mitral valve replacement. J Thorac Cardiovasc Surg 1975;69:259.
4. Stephenson LW, MacVaugh H, Edmunds LH. Surgery using cardiopulmonary bypass in the elderly. Circulation 1978; 58:250
5. David TE. Left Ventricular Rupture After Mitral Valve Replacement. J Thorac Cardio-vasc Surg Open 2020;3: 48-9.
6. KJ Karlson, Ashraf MM, and Berger RL. Rupture of Left Ventricle FolIowing Mitral Valve Replacement. Ann Thorac Surg 1988; 46:590-597.
7. Miller DW Jr., Johnson DD, and Ivey TD. Does Preservation of the Posterior Chordae Tendineae Enhance Survival during Mitral Valve Replacement? Ann Thorac Surg 1979; 28, (1): 22-27.
8. Chowdhury UK, Singh S, George N, Sankhyan LK, Gudala V, Chauhan A et al. A Treatise on The Surgical Management and A Suggested Amendment of Surgical Classification of Left Ventricular Rupture Following Mitral Valve Replacement. J Integrative cardiology open access 2019 V.2(3)5-23. http://dx.doi.org/10.31487/j.JICOA.2019.03.01
9. Sersar SI, and Jamjoom AA. Left Ventricular Rupture Post Mitral Valve Replacement. Clinical Medicine: Cardiology 2009:3 101–113
10. Denis H, Sokullu O, Sanioglu S, et al. Risk factors for posterior ventricular rupture after mitral valve replacement: results of 2560 patients. Eur J Cardiothorac Surg 2008;34:780–4.
11. Azariades M, and Lennox SC. Rupture of the Posterior Wall of the Left Ventricle after Mitral Valve Replacement: Etiological and Technical Considerations. Ann Thorac Surg 1988;46:491-94
12. Dark JH, Bain WH. Rupture of posterior wall of left ventricle after mitral valve replacement. Thorax 1984;39:905-911.
13. Schuetz A, Schulze C, Wildhirt SM. Off-pump epicardial tissue sealing-- a novel method for atrioventricular disruption complicating mitral valve procedures. Ann Thorac Surg 78: 569-573.
14. Zhang HJ, Ma WG, Xu JP, Hu SS, Zhu XD. Left Ventricular Rupture after Mitral Valve Replacement: A Report of 13 Cases. Asian Cardiovasc Thorac Ann 2006;14:26–9.
15. Nya F, Mounir R, El Bekkali Y, Ait Houssa M. Cardiac autotransplantation for repair of left ventricular rupture after mitral valve replacement. Indian J Thorac Cardiovasc Surg 2020 36(5):509–51.

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