A Case of Anterolateral Papillary Muscle Rupture Caused by a Diagonal Branch Occlusion

(Department of Cardiovascular Surgery, Kikuna Memorial Hospital, Yokohama, Japan)

Atsushi Bito Noboru Murata Noboru Yamamoto
We encountered an instructive case of anterolateral papillary muscle rupture after acute myocardial infarction. A73-year-old woman with rapidly progressive dyspnea came to our emergency room. Her symptoms associated with acute heart failure rapidly worsened. We diagnosed anterolateral papillary muscle rupture after acute myocardial infarction due to occlusion of the first diagonal branch, based on transesophageal echocardiogram and coronary angiography. We immediately performed mitral valve replacement and coronary artery bypass grafting (CABG) to the diagonal branch. Although she required postoperative intraaortic balloon pumping (IABP) and percutaneous cardiopulmonary support (PCPS), she eventually recovered. Mitral papillary muscle rupture causes rapidly deteriorating hemodynamics and requires surgical treatment. Because of a serious complication of myocardial infarction, this case emphasizes that early diagnosis and aggressive treatment are required for mitral papillary muscle rupture.
@Jpn. J. Cardiovasc. Surg. 35: 45-48 (2006)