[Rupture of the middle left ventricle after a mitral valve replacement. A report on 27 autopsy cases].

Left ventricular rupture is a serious complication of mitral valve replacement. The prevalence ranged from 0.5 to 14%, and is the principal cause of early postoperative death following mitral valve replacement. In this report we described certain morphologic observations and some clinical and epidemiological data of a series of 27 necropsy patients with midventricular rupture (type III). This complication was predominantly present in females (88.9%) with an average age of 44 +/- 11.4 years. The predominant valvular lesion was stenosis (70.4%). In all cases we found small-sized left ventricles and the ventricular wall hypertrophied. Perforation was observed in the 18.5% of the cases. In 59.2% of the patients high profile prostheses were used. Seventy-eight percent of patients died before 24 hours with refractory ventricular failure and only in the 25.9% of cases the clinical diagnoses was suspected and rupture unsuccessfully repaired. Our results suggested that age, sex, type of mitral lesion, ventricular size and type of prostheses are not risk factors for this complication. The mortality is high and the diagnosis was not suspected frequently. Midventricular rupture of the left ventricle is a lethal complication and is necessary to know all its characteristics to implement better methods of prevention and management.