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You are here: Contents > 2017 > Volume 26 Number 2 March 2017 > CASE REPORTS > Papillary Muscle Rupture in an Adolescent with No Coronary Lesions

Papillary Muscle Rupture in an Adolescent with No Coronary Lesions

Tatjana Lejko Zupanc1,2, Mateja Logar1

1Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan
2Department of Cardiovascular Medicine, Chiba University Hospital, Chiba, Japan
3Department of Diagnostic Pathology, Chiba University Hospital, Chiba, Japan
4Department of Pathology and Biobank, National Cerebral and Cardiovascular Center, Suita, Japan
5Electronic correspondence: bpbck570@ybb.ne.jp

A 21-year-old man with Wolff-Parkinson-White syndrome presented to the authors’ hospital with ventricular fibrillation. Coronary angiography failed to demonstrate coronary stenosis, but temporary mechanical circulatory support resolved the ventricular fibrillation and the patient was extubated eight days later. On the next day, however, he had to be re-intubated with symptoms of congestive heart failure. Echocardiography revealed new severe mitral regurgitation and a mobile mass, while emergency surgery revealed a posteromedial papillary muscle rupture (PMR). The mitral regurgitation was repaired with ruptured papillary muscle relocation, artificial chordae implantation, and ring annuloplasty. Postoperative examinations suggested that an arrhythmia-induced coronary circulation hypoperfusion and septic embolization had caused the PMR.

The Journal of Heart Valve Disease 2017;26:231-233


Papillary Muscle Rupture in an Adolescent with No Coronary Lesions

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