Atrioventricular Groove Rupture After Mitral Valve Replacement In A Patient With Atrial Fibrillation Secondary To Rheumatic Cardiopatia: Case Report

Abstract

Introduction: Atrioventricular sulcus lesion (AVGD) is a catastrophic complication of mitral valve surgeries that occurs in less than 2% of the population, with a mortality of 90%. Left ventricular rupture after mitral valve (MVR) replacement should be diagnosed immediately and repaired without hesitation. There are numerous complications described and known after MVR, such as thromboembolism, structural valve degeneration and endocarditis, paravalvular leakage, conduction irregularities in the pathway and bleeding. Case presentation: We present the case of a female patient with a history of rheumatic heart disease with double mitral injury and atrial fibrillation, in which severe mitral stenosis was documented with ECOTT reflecting thrombi of heterogeneous appearance occupying almost entirely left atrium. Programmed for left auriculotomy, valve replacement and thrombus exceresis, resulting in the procedure lesion of the atrioventricular groove meriting packing of the same and placement of mediastinal probes, with subsequent admission to post-surgical coronary care unit. Conclusions: At present, atrioventricular groove rupture is a rare event with increased mortality, the incidence depends on age and associated risk factors in the patient, In our case, rheumatic heart disease generates arrhythmias as a procoagulant state. Although the rupture can be repaired in a second surgical time, follow-up and post-operative care require comprehensive medical equipment and continuous hemodynamic surveillance.