Mortality Rates of Surgical Techniques for Correcting Atrioventricular Disjunction.

Élcio Pires Junior,Marcelo Luiz Peixoto Sobral

doi:10.21470/1678-9741-2020-0041

Abstract

We compared the mortality rates of two surgical techniques for correction of atrioventricular disjunction in 10 out of 720 patients who underwent mitral valve replacement from 2005 to 2012. In group I, the mitral annulus was fixed with bovine pericardial strips; in group II, a 'patch' of bovine pericardium was sutured and extended from the base of the lateral and medial papillary muscles, covered the posterior wall of the left ventricle, went through the posterior mitral annulus, and ended in the posterior wall of the left atrium adjacent to the mitral ring. The group II technique showed a lower mortality.

Highlights

Atrioventricular disjunction associated with left ventricular rupture (LVR) is a rare and serious complication following mitral valve replacement (MVR)[1]
The sample for this study consisted of 10 patients with LVR after MVR
LVR was corrected by fixing the mitral annulus with strips of bovine pericardium and in the remainder, the suture technique for an extra-annular bovine pericardium patch was used

Summary

Introduction

Atrioventricular disjunction associated with left ventricular rupture (LVR) is a rare and serious complication following mitral valve replacement (MVR)[1]. It was initially described by Roberts and Morrow, in 1967, from autopsy findings in two patients[2]. The etiology of LVR includes the replacement of a previously implanted prosthesis, selecting a larger prosthesis than the mitral annulus and the left ventricle, weakness of the left ventricular wall due to cardiomyopathy, mechanical traction injuries of the mitral annulus, and excessive papillary resection, while the key factors are mitral stenosis and calcification of the mitral annulus[4]. A safe and reproducible surgical technique is necessary for dealing with this complication. We compared the mortality rates of two surgical techniques for the correction of LVR

Methods

Results

Discussion

Conclusion