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Mitral valve surgery for acute papillary muscle rupture
Authors:Ibrahim Sultan MD  Edgar Aranda‐Michel  Thomas G. Gleason MD  Forozan Navid MD  Arman Kilic MD
Affiliation:1. Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania;2. Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
Abstract:

Background

Papillary muscle rupture (PMR) is a rare complication of a myocardial infarction. The aim of this study was to review our results of mitral valve surgery for acute PMR.

Methods

Data from patients undergoing emergent mitral valve surgery for acute PMR between 2011 and 2017 at our institution were reviewed. Outcomes included operative morbidity and mortality, mitral valve reoperation, and hospital readmission.

Results

A total of 2479 patients underwent mitral valve surgery during the study period including 24 (1.0%) for PMR. Mean age was 62 years, and two (8.3%) patients had prior open‐heart surgery. Overall Society of Thoracic Surgeons predicted risk of mortality was 17.5%. Operative mortality was 12.5% (n = 3) with an observed‐to‐expected mortality ratio of 0.71. There were no strokes, and new onset dialysis was required in two (8.3%) patients. Mean follow‐up was 2.40 ± 1.96 years. Three‐year mortality, mitral valve reoperation, and readmission rates were 21.1%, 5.0%, and 45.4%.

Conclusions

Expeditious operative intervention for PMR can be associated with acceptable operative and longer‐term outcomes.
Keywords:mitral regurgitation  mitral valve repair  mitral valve replacement  papillary muscle rupture
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