Left Ventricular Rupture After Mitral Valve Replacement

Objective: To discuss the causes and treatment of delayed left ventricular ruptureafter mitral valve replacement(MVR).Material and methods: We analyzed clinical data of2patients who had delayedleft ventricular rupture after MVR,among a total of1000MVR patients,between Mar2007and sept2013in our hospital, Both of two female patients were female and withmitral stenosis. Case1:a female,49years old, weight:50kg, NYHA:III, LVEF:58%,LVEDD:46mm. Case2:a female,60years old, weight:50kg, NYHA:III, LVEF：60%，LVEDD：37mm.Both patients’ mitral valve were removed under cardiopulmonarybypass in low temperature during anesthesia.Atrial fibrillation Radiofrequency ablationwas in case1patient with mitral valve replacement (MVR).Atrial fibrillationRadiofrequency ablation and aortic valve replacement were in case2patient with mitralvalve replacement.Results:Left ventricular rupture occurred in two patients in the ICU. Case1fortype III rupture, case2for type II rupture.After the left ventricular rupture wasrepaired,the patients get back to ICU.Case1patient died of low cardiac outcomesyndrome. Case2patient was successfully healed and discharged from hospital14daysafter the operation.Conclusion:Delayed rupture is difficult to repair with a high Mortality.Effective prevention strategy should be applied to avoid it as much as possible.Once left ventricular rupture occurs,cardiopulmonary bypass should be quicklyestablished. The correct surgical repair technology plays the important role in successfulrescue.