Rupture of the posterior wall of the left ventricle after mitral valve replacement.

During a 20 year period from 1970 to 1989, 1100 patients underwent mitral valve replacement. Rupture of the posterior wall of the left ventricle occurred in seven patients (0.6%); four in the operating room and three in the postoperative room. It was possible to institute CP bypass in six patients and in all of them bleeding was controlled successfully, with repair by an external approach. Only one patient survived. We believe that institution of CP bypass and reinfusion of cardioplegic solution is a major determinant of the outcome.