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Ann Thorac Surg 1983;35:243-248
© 1983 The Society of Thoracic Surgeons

Articles

Surgical Treatment of Papillary Muscle Rupture

Duncan A. Killen, M.D.1, William A. Reed, M.D., Suchint Wathanacharoen, M.D., Gary Beauchamp, M.D., Barry Rutherford, M.D.

From the Mid-America Heart Institute of the Saint Luke's Hospital, Kansas City, MO

Accepted for publication February 18, 1982.

Between 1971 and 1979, 16 patients underwent mitral valve replacement for papillary muscle rupture after infarction. Nine of these patients were operated on within 3 days of papillary muscle rupture. Eight patients had low cardiac output syndrome prior to operation. Six patients had concomitant coronary artery bypass, and 1 patient had resection of an associated left ventricular aneurysm. There were 3 operative deaths (19% mortality). Surviving patients have been followed for a total of 49 patient-years. There have been 2 late deaths, each a result of coronary artery disease. Six of the 11 surviving patients are asymptomatic; the others are in New York Heart Association Functional Class II or III. The actuarial 5-year survival was 75%. These data support the concept that an aggressive attitude should be taken toward early diagnosis and surgical treatment of postinfarction papillary muscle rupture.




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