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  • Title: [Left ventricular perforation after insertion of a mitral prosthesis. 6 cases].
    Author: Blétry O, Perrault M, Langlois J, Gourgon R, Slama R, Bouvrain Y.
    Journal: Nouv Presse Med; 1975 Oct 11; 4(33):2371-5. PubMed ID: 1196857.
    Abstract:
    The external ruptures of the left ventricule occuring in the first twelve postoperative hours and demonstrated by a disastrous haemorrhage or cardiac failure, the other traumatics accidents could be delayed and be observed during the first month, or even later. Essentially two mechanisms are implicated: -- Direct traumatism by a ball valve on the ventricular septrum. -- Sub-annular splitting in connection with the excision of a piece of calcareous valve. Two lines of approch can be offered to avoid these accidents: -- Choose a disc valve when the surgeon finds a small left ventricle below a stenosed and calcified mitral valve. -- Care in the decalcification of the mitral ring and the valvular resection, leaving in case of need a small calcified cuff for safety. The analysis of these findings clarify the main causes of left ventricular rupture after mitral replacement, rare complications, but ones which are very real.
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