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==Overview==
==Overview==
[[Papillary muscle]] rupture is an infrequent mechanical complication of [[acute myocardial infarction]]. Early diagnosis is important so that surgical repair can be performed.
[[Papillary muscle]] rupture is an infrequent mechanical complication of [[acute myocardial infarction]]. Early diagnosis is important so that surgical repair can be performed.



Revision as of 23:30, 15 April 2012

Papillary muscle rupture
Papillary Muscle Infarct with Rupture: Gross, an excellent example of ruptured papillary muscle.
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

For patient information click here

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Papillary muscle rupture is an infrequent mechanical complication of acute myocardial infarction. Early diagnosis is important so that surgical repair can be performed.

Pathophysiology

The vascularization of the papillary muscles shows many individual variations and depends in part on coronary artery anatomy and dominance. However, the posterior papillary muscle is vascularized by posterior left ventricular branches that may have origin in the right, left or both coronary arteries. The anterior papillary muscle is vascularized by branches from diagonal, circumflex or even acute marginal branches of the left coronary artery. Papillary muscle ischemia occurs along with ischemia of the adjacent ventricular wall.

Echocardiographic Findings of Ruptured Papillary Muscle and Severe MR

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Pathological Findings

Images shown below are courtesy of Professor Peter Anderson DVM PhD and published with permission. © PEIR, University of Alabama at Birmingham, Department of Pathology

References

  • Kyo S, Miyamoto N, Yokote Y, et al. [Papillary muscle rupture complicating acute myocardial infarction--treatment with mitral valve replacement and coronary bypass surgery in acute phase] Nippon Kyobu Geka Gakkai Zasshi 1996 Jun; 44(6):874-81.
  • Tavakoli R, Weber A, Vogt P, et al. Surgical management of acute mitral valve regurgitation due to post-infarction papillary muscle rupture. J Heart Valve Dis 2002 Jan; 11(1):20-5; discussion 26.
  • Nunley DL, Starr A Papillary muscle rupture complicating acute myocardial infarction. Treatment with mitral valve replacement and coronary bypass surgery. Am J Surg 1983 May; 145(5):574-7.
  • Goh K, Kubo Y, Sasajima T, et al. [Emergency CABG and mitral valve replacement for anterolateral papillary muscle rupture after acute myocardial infarction] Nippon Kyobu Geka Gakkai Zasshi 1995 Jul; 43(7):1034-8.
  • Yanagi H, Kondo J, Uchida K, et al. [A case of emergency surgery for acute mitral regurgitation due to complete papillary muscle rupture as complication of acute inferior myocardial infarction] Jpn J Thorac Cardiovasc Surg 1998 Oct; 46(10):1014-9.
  • Sasaki Y, Suehiro S, Shibata T, et al. [Mitral valve replacement and coronary artery bypass grafting for postinfarction mitral papillary muscle rupture] Nippon Kyobu Geka Gakkai Zasshi 1996 May; 44(5):697-701.
  • Minakata K, Konishi Y, Matsumoto M, et al. [A case of scheduled mitral valve replacement for mitral regurgitation caused by papillary muscle rupture after acute myocardial infarction] Nippon Kyobu Geka Gakkai Zasshi 1997 Apr; 45(4):639-44.
  • Tepe NA, Edmunds LH Operation for acute postinfarction mitral insufficiency and cardiogenic shock. J Thorac Cardiovasc Surg 1985 Apr; 89(4):525-30.
  • Ueno Y, Toba T, Ezaki H, et al. [Mitral valve replacement with concomitant coronary bypass for the papillary muscle rupture after acute myocardial infarction in situs inversus] Kyobu Geka 1992 Oct; 45(11):1031-4.
  • Minami H, Mukohara N, Obo H, et al. Papillary muscle rupture following acute myocardial infarction. Jpn J Thorac Cardiovasc Surg 2004 Aug; 52(8):367-71.


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