Left ventricular rupture after mitral valve replacement

Background. What are the immediate and long term outcomes of patients who h ad rupture of the left ventricle after mitral valve replacement? Methods. Experimental design: A retrospective study with a 20-year follow-u p. Setting: Experience in a single tertiary referral cardiothoracic surgery hospital. Participants: 20 out of 3105 patients that received mitral valve replacement. Intervention: All these 20 patients received re-exploration f or a trial of repair of left ventricular rupture either by an internal or a n external or a combined repair. Measures: Operative mortality and long ter m outcome of the survivals. Results. Most patients (16.80%) mere female and had rheumatic mitral valve disease. The mean age of the patients was 58.1 years. All patients underwen t attempted repair, usually by removal of the prosthesis and reconstitution of the ventricle from within the left atrium (75%). Thirteen (65%) patient s died. Two late deaths were of unrelated cause. One surviving patient deve loped a late ventricular false aneurysm but did not undergo repeat surgery. One patient developed severe mitral regurgitation due to tissue failure of the bioprosthesis 12 years after surgery and she underwent a successful re operation. Conclusions. We believe that all patients should be placed back on cardiopu lmonary bypass for an internal repair. The long term outcome of the surviva ls is satisfactory.