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Ann Thorac Surg 1979;27:130-132
© 1979 The Society of Thoracic Surgeons

Articles

Posterior Midventricular Rupture after Mitral Valve Replacement

Gordon Katske, M.D., Leonard R. Golding, M.D.*, Raymond R. Tubbs, D.O., Floyd D. Loop, M.D.

From the Department of Thoracic and Cardiovascular Surgery, and the Department of Pathology, The Cleveland Clinic Foundation and The Cleveland Clinic Educational Foundation, Cleveland, OH

Accepted for publication June 8, 1978.

* Address reprint requests to Dr. Golding, Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44106

Posterior midventricular rupture occurred in 3 patients after insertion of a mitral prosthesis. Iatrogenic surgical trauma was not implicated. There were five clinical factors common to each case: a woman with mitral stenosis; a left ventricle of relatively normal size; the use of intermittent cold cardioplegia; the insertion of a porcine heterograft valve; and transient postoperative hypertension. Rupture in such cases may be caused by hyperdynamic left ventricular contraction against the strut of the prosthesis. Causes of ventricular perforation are discussed.




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