ORBi: Defraigne Jean-Olivier - Le remplacement valvulaire mitral pour rupture de pilier mitral post-infarctus. A propos de 13 cas opérés à la phase aigue de l'infarctus

Reference : Le remplacement valvulaire mitral pour rupture de pilier mitral post-infarctus. A propos...


	Document type :	Scientific journals : Article
	Discipline(s) :	Human health sciences : Surgery Human health sciences : Cardiovascular & respiratory systems
	To cite this reference:	http://hdl.handle.net/2268/128169

Title :	Le remplacement valvulaire mitral pour rupture de pilier mitral post-infarctus. A propos de 13 cas opérés à la phase aigue de l'infarctus
Language :	French
Alternative title :	[en] Mitral Valve Replacement in Post-Infarction Rupture of the Papillary Muscle. Apropos of 13 Cases Surgically Treated During the Acute Phase of Infarction
Author, co-author :	Defraigne, Jean-Olivier [Université de Liège - ULg > Département des sciences cliniques > Chirurgie cardio-vasculaire et thoracique >]
	Lavigne, J. P. [> > > >]
	Remy, D. [> > > >]
	DEKOSTER, Guy [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie cardio-vasculaire >]
	Limet, Raymond [Université de Liège - ULg > Département des sciences cliniques > Chirurgie cardio-vasculaire et thoracique]
Publication date :	Mar-1990
Journal title :	Archives des Maladies du Coeur et des Vaisseaux
Publisher :	J. B. Bailliere et Fils
Volume :	83
Issue/season :	3
Pages :	377-82
Audience :	International
ISSN :	0003-9683
City :	Paris
Country :	France
Abstract :	[en] Between 1983 and 1988, thirteen patients (12 men and 1 women, average age 63 years) were operated in the acute phase of myocardial infarction for papillary muscle rupture (PMR). The rupture involved the posterior papillary muscle in 12 cases. The average left ventricular ejection fraction was 47 +/- 9 per cent (range 34 to 63%). Pulmonary capillary pressures ranged from 76 to 41 mmHg (average 35 mmHg). Eleven patients presented with acute pulmonary oedema and 7 had cardiogenic shock. Coronary arteriography showed triple vessel disease in 3 cases, double vessel disease in 7 cases and single vessel disease in 3 cases. Surgery was carried out on average 2.7 days after the rupture and 10 days after the initial infarct. In addition to mitral valve replacement (N = 13), 11 patients underwent a myocardial revascularisation procedure. The operative mortality was 15 per cent (N = 2). Papillary muscle rupture in the acute phase of myocardial infarction causes cardiac failure which is related more to the mechanical abnormality than to an alteration of left ventricular function. Considering the operative mortality and the natural history of PMR treated medically, the authors recommend early surgery as the only management which can improve the precarious haemodynamic status of patients with this complication.
Target :	Researchers ; Professionals ; Students
Permalink :	http://hdl.handle.net/2268/128169

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