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European Heart Journal 1988 9(9):1030-1033;
Copyright © 1988 by the European Society of Cardiology.
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© 1988 The European Society of Cardiology

Traumatic papillary muscle dysfunction: attempted mitral-valve repair and eventual prosthetic replacement

S. AL KASAB*,, S. WESTABY{dagger}, M. A. AL ZAIBAG*, M. HABBAB*, K. A. GUNAWARDENA* and M. R. AL FAGIH*

*Riyadh Cardiac Centre, Armed Forces Hospital Riyadh, Saudi Arabia
{dagger}John Radcliffe Hospital Oxford U.K.

Received 29 October 1987; revised 9 February 1988; .

Requests for reprints Dr S. Al Kasab. MRCP. E226. Armed Forces Hospital, P.O. Box 7897, Riyadh 11159. Kingdom of Saudi Arabia

Abstract

A previously healthy young man sustained a deceleration chest injury. Severe mitral regurgitation was confirmed by Doppler and cardiac catheterisation. The mitral valve and subvalvular apparatus appeared normal at the subsequent surgery. Papillary muscle dysfunction was considered to be the principal cause of the regurgitation. Mitral-valve repair failed to preserve the competence of the valve, leading to successful mitral-valve replacement. Histology of the papillary muscle showed necrosis, confirming the original diagnosis. Post-traumatic papillary muscle dysfunction is concluded to be one of the causes of severe mitral regurgitation. Appropriate treatment is valve replacement rather than attempting conservative management.

Key Words: Trauma • papillary muscle • mitral regurgitation


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