Vazquez Alejandro, Osa Ana, Vicente Rosario, Montero Jose A
Department of Cardiac Surgery, Hospital Universitari i Politècnic La Fe, Valencia, Spain
Department of Cardiology, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
Interact Cardiovasc Thorac Surg. 2014 Sep;19(3):535-6. doi: 10.1093/icvts/ivu170. Epub 2014 May 29.
Left ventricular free wall rupture and acute ischaemic mitral regurgitation are nowadays rare, but still potentially lethal mechanical complications after acute myocardial infarction. We report a case of a sequential left ventricular free wall rupture, anterolateral papillary muscle disruption, secondary severe mitral regurgitation and subsequent posteromedial papillary muscle head rupture in a single patient during the same ischaemic episode after myocardial infarction, and their related successful surgical procedures and management until discharge. Prompt bedside diagnosis and emergent consecutive surgical procedures, as well as temporary left ventricular assistance, were crucial in the survival of this patient.
左心室游离壁破裂和急性缺血性二尖瓣反流如今较为罕见，但仍是急性心肌梗死后潜在的致命机械并发症。我们报告了一例患者，在心肌梗死后的同一缺血发作期间，先后出现左心室游离壁破裂、前外侧乳头肌断裂、继发性严重二尖瓣反流以及随后的后内侧乳头肌头部破裂，以及与之相关的成功手术过程和直至出院的管理情况。床边快速诊断、紧急连续手术以及临时左心室辅助对该患者的存活至关重要。
