Key result
Emergency MVR with CABG salvages complete anterolateral papillary muscle rupture in cardiogenic shock.
Why the study?
Papillary muscle rupture is a lethal complication after acute myocardial infarction requiring urgent surgical management to improve prognosis.
Case Report (n=1)
No
Supports salvage feasibility in selected high-risk papillary muscle rupture; leaves open optimal patient selection and generalizability.
Papillary muscle rupture is a lethal complication of after acute myocardial infarction. We report the successful surgical management of complete anterolateral papillary muscle rupture associated with cardiogenic shock in an 80-year-old woman. The patient was admitted with the sudden onset of chest pain and dyspnea. After hemodynamics deteriorated rapidly, she was intubated and intra-aortic balloon pump was started immediately. Transthoracic echocardiography revealed severe mitral regurgitation due to complete anterolateral papillary muscle rupture associated with lateral myocardial infarction. Coronary angiography demonstrated complete occlusion of the first obtuse marginal artery. She underwent emergency mitral valve replacement and coronary artery bypass grafting. There were no complications of surgery and she was discharged on postoperative day 35. Rapid preoperative assessment and aggressive surgical management are important to improve the prognosis in this setting.
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Doi et al. (2014) conducted a case report in Complete anterolateral papillary muscle rupture following acute myocardial infarction (n=1). Emergency mitral valve replacement and concomitant coronary artery bypass grafting was evaluated on Survival and recovery. Emergency mitral valve replacement and concomitant coronary artery bypass grafting successfully salvaged an 80-year-old woman with complete anterolateral papillary muscle rupture and cardiogenic shock.
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