Infarction of Papillary Muscles and Mitral Insufficiency Associated with Congenital Aortic Stenosis

Study of the papillary muscles in 11 infants dying in the first year of life with congenital aortic stenosis and normal coronary arteries demonstrated infarction of the left ventricular papillary muscles in each. Lesions were more extensive in the posteromedial than in the anterolateral papillary muscle. Infarction of papillary muscles is considered the basis for the common occurrence of mitral insufficiency in symptomatic infants with congenital aortic stenosis. Congenital aortic stenosis, infarction of left ventricular papillary muscles, and mitral insufficiency are so interrelated as to constitute a syndrome.