PAPILLARY-MUSCLE RUPTURE IN ACUTE MYOCARD IAL-INFARCTION

We report nine patients with acute mitral regurgitation secondary to p ost-infarction papillary rupture operated between 1980 and 1992. Seven cases had posterior papillary muscle rupture. All patients were in cr itical conditions with pulmonary edema at the moment of surgery. In ei ght cases, mitral valve replacement was performed (4 with mechanical p rotheses) and in one, the valve was repaired with papillary muscle rei mplantation. Six cases were also subjected to myocardial revasculariza tion with sapheneous vein grafts. Two patients (22%) died during the p ostoperative period and 4 had postoperative complications. The seven s urvivors have been followed during 6 to 225 month. Of theses, one died six month after surgery due to congestive heart failure, three are in functional class I and the rest in functional class II. It is conclud ed that although mitral valve replacement for papillary muscle rupture has a high operative mortality and morbidity, long term results are s atisfactory.