| Emergency Double Valve Replacement
for Acute Mitral Regurgitation due to Ruptured Chordae Tendineae
Associated with Congenital Bicuspid Aortic Valve Insufficiency |
(Department of Cardiac Surgery, Jikei University
Kashiwa Hospital, Chiba, Japan, Department of Cardiac Surgery,
Jikei University School of Medicine*, Tokyo, Japan and Department
of Cardiovascular Surgery, Saitama Cardiovascular and Respiratory
Center**, Saitama, Japan)
| Motohiro Oshiumi |
Kiyozou Morita* |
Kazuhiro Hashimoto** |
| Asatoshi Mizuno |
Hiromitsu Takakura** |
Hirokuni Naganuma |
|
We present a rare case of mitral
valve prolapse associated with congenital bicuspid aortic valve,
followed by abrupt left chordae tendineae rupture resulting in
severe left heart failure and cardiac arrested. The patient,
a 43-year-old man who had been admitted because of sudden orthopnea
suffered cardiac arrest on arrival in the emergency unit. After
successful cardiopulmonary resuscitation, emergency double-valve
replacement (SJM25mm for the aortic valve and Carbomedics 31mm
for the mitral valve) was performed; his postoperative course
was uneventful. Concerning the pathogenesis of the acute rupture
of the chordae tendineae in this patient with no evidence of
infective endocarditis, it was likely that chronic and progressive
left ventricular volume overload due to aortic regurgitation
caused by congenital bicuspid aortic valve was the causative
factor of abrupt rupture of the chordae tendineae during the
course of mild mitral valve prolapse.
Jpn. J. Cardiovasc. Surg. 31: 425-427 (2002) |
|
