Key result
Percutaneous mechanical circulatory support with Impella CP and emergent mitral valve replacement were utilized to manage a patient with cardiogenic shock secondary to iatrogenic papillary muscle rupture.
Why the study?
Papillary muscle rupture is typically seen after myocardial infarction but can less commonly occur as an iatrogenic complication of cardiac procedures.
Case Report (n=1)
This case highlights a rare but life-threatening complication of left ventricular angiography (iatrogenic papillary muscle rupture) and its successful management with mechanical circulatory support and emergent surgery.
Prompt Impella support plus emergent surgery can stabilize iatrogenic papillary muscle rupture; extends recognition of this rare LV angiography complication.
Papillary Muscle rupture is a rare and potentially life-threatening complication that is typically observed in the days following acute myocardial infarction. Less commonly, rupture of a papillary muscle may arise as an iatrogenic complication of cardiac procedures. We present a case of cardiogenic shock in the setting of torrential mitral regurgitation secondary to iatrogenic papillary muscle rupture during a left ventricular angiogram. The patient was placed on percutaneous mechanical circulatory support with Impella CP and transferred for emergent mitral valve replacement. This case highlights the potential complications of minimally invasive cardiac procedures and reviews the management of acute severe mitral regurgitation.
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Marsalisi et al. (2024) conducted a case report in Cardiogenic shock and torrential mitral regurgitation secondary to iatrogenic papillary muscle rupture (n=1). Impella CP and emergent mitral valve replacement was evaluated. Percutaneous mechanical circulatory support with Impella CP and emergent mitral valve replacement were utilized to manage a patient with cardiogenic shock secondary to iatrogenic papillary muscle rupture.
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