Successful Surgical Treatment for Anterior Papillary Muscle Rupture Caused by Isolated First Diagonal Branch Occlusion

(First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan)

Kazuhiro Ohkura Norihiko Shiiya Katsushi Yamashita
Naoki Washiyama Masato Suzuki Daisuke Takahashi
Ken Yamanaka
A 62-year-old woman was admitted to a regional hospital for acute myocardial infarction. Emergency coronary angiography revealed occlusion of the first diagonal branch, and transesophageal echocardiography showed severe mitral regurgitation due to anterior papillary muscle rupture. She was transferred to our hospital in a state of cardiogenic shock despite the use of high-dose catecholamine and intra-aortic balloon pumping. We immediately performed mitral valve replacement. The patient’s postoperative course was uneventful and she was ambulatory when transferred to another hospital on foot on postoperative day 19. Physicians should be aware that fatal anterior papillary muscle rupture may be caused by isolated occlusion of the diagonal branch.
  Jpn. J. Cardiovasc. Surg. 41:165-168(2012)

Keywords:acute myocardial infarction, papillary muscle rupture, acute mitral regurgitation, first diagonal branch