Echocardiographic localization of left ventricular free wall rupture after minimally invasive mitral valve replacement

Abstract

LEFT VENTRICULAR RUPTURE is a rare but severe complication of mitral valve replacement associated with a mortality that exceeds 75%.1 The choice of initial intervention depends on the site of left ventricular rupture.1,2 However, the precise determination of the site and extent of the injury can be extremely difficult in the setting of ongoing bleeding and limited ability to expose the posterior left ventricular wall. Transesophageal echocardiography (TEE), which has become a standard intraoperative diagnostic tool in treatment of patients with mitral valve disease, can offer vital information regarding the site of the ventricular rupture. A patient is described in whom successful repair of left ventricular free wall rupture was performed after minimally invasive valve replacement.