The underlying causes of chordae tendinae rupture: A systematic review

Gabbay, Uri; Yosefy, Chaim

doi:10.1016/j.ijcard.2010.02.011

Cited by 59 publications

(50 citation statements)

References 40 publications

(34 reference statements)

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“…In adolescents and adults, the underlying causes of the rupture of the chordae tendineae are diverse [2][3][4][5][6][7][8][9][10][11][12][13] ; mitral valve prolapse, myxomatous degeneration, and infectious endocarditis are the leading causes, particularly in the last 2 decades. 2 In infants, causes of the rupture appear to be different from those in adults; most pediatric cases of mitral rupture were diagnosed as idiopathic because a direct cause could not be demonstrated.…”

Section: Causes Of the Diseasementioning

confidence: 99%

Acute Rupture of Chordae Tendineae of the Mitral Valve in Infants

et al. 2014

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Background— Recently, infant cases of acute heart failure attributable to rupture of the mitral chordae tendineae have been reported. However, little is known about the pathogenesis and clinical course of this condition. Methods and Results— Ninety-five children with rupture of mitral chordae tendineae were identified in nationwide surveys of Japan diagnosed from 1995 to 2013. The clinical manifestations, management strategies, and prognosis were investigated. Eighty-one (85%) patients were between 4 and 6 months (median, 5 months) of age. In 63 (66%) patients, rupture occurred during the spring or summer. The underlying conditions before rupture included Kawasaki disease (10 cases), maternally derived anti-SSA antibodies (2 cases), and infective endocarditis (1 case). Surgery was performed in 80 patients (94 operations), and the final operations included plasty of mitral chordae in 52 cases and mechanical valve replacement in 26 cases. The histopathologic examinations of the mitral valves and chordae (n=28) revealed inflammatory reactions with predominant mononuclear cell infiltration in 18 cases (64%) and increased fibrous and myxoid tissue in 11 cases (39%), suggesting that nonbacterial infectious or autoimmune endocarditis and myxoid changes are involved in the pathogenesis. Eight patients (8.4%) died before (n=6) and shortly after (n=2) the operation, and significant neurological complications persisted in 10 cases (11%). Conclusions— Acute heart failure attributable to rupture of the mitral chordae tendineae in infants is a unique disease resulting from diverse causes. This condition should be recognized as a significant cardiovascular disorder that may cause sudden onset of cardiogenic shock and death in infants.

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Section: Causes Of the Diseasementioning

confidence: 99%

Acute Rupture of Chordae Tendineae of the Mitral Valve in Infants

et al. 2014

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“…Although rupture of chordae tendineae in MFS is rare complication, it leads to serious consequences such as severe heart failure acute surgical emergencies and death [3][4][5] . Gabbay and Tosefy reported in their review article [8] that the underlying causes of chordae tendinae rupture are mitral valve prolapse (44.5%), subacute bacterial endocarditis (37.4%), rheumatic heart disease (24.8%), myxo-matous degeneration (11.7%) and ischemic heart disease (1.4%). Systemic connective tissue disorder such as MFS, osteogenesis imperfecta, and Ehler-Danlos syndrome are also causes.…”

Section: Discussionmentioning

confidence: 99%

An unusual finding of left ventriculography in Marfan syndrome with severe mitral valve prolapse

Kimura¹,

Takahashi²,

Kawai³

et al. 2015

Cardio Vasc Syst

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A 16-year-old boy with Marfan syndrome was scheduled for open-heart surgery for dilated aortic sinuses of Valsalva. Preoperative cardiac catheterization with left ventricular angiography demonstrated bulging at the junction of the mitral annulus with an appearance like 'a swim ring'. Transthoracic echocardiography showed severe mitral prolapse with the mitral valve leaflets rising toward the left atrium and stretching of the chordae tendineae. ECG-gated contrast CT revealed that this bulging was not the left ventricle itself but the interspace between the base of the left ventricle and mitral valve leaflets. This bulging disappeared after mitral valve plasty with an annuloplasty ring. This unusual finding might herald chordae tendinae rupture in Marfan syndrome.

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“…Chordae tendineae rupture is seen most commonly as the result of (in descending order of frequency) mitral valve prolapse, sub‐acute bacterial endocarditis, rheumatic heart disease, and myxomatous degeneration 9 . Chordae tendineae rupture differs from papillary muscle rupture in that the first is rarely caused by ischaemia and, depending on the number of chords affected, may not produce symptoms 9 .…”

Section: Discussionmentioning

confidence: 99%

“…Chordae tendineae rupture differs from papillary muscle rupture in that the first is rarely caused by ischaemia and, depending on the number of chords affected, may not produce symptoms 9 . Significant rupture causes FML and presents in a similar fashion to PMR both clinically and echocardiographically.…”

Section: Discussionmentioning

confidence: 99%

Three patients with signs of acute flail mitral leaflet seen on emergency department echo: a critical constellation within the focused cardiac exam

Bomann

Stephenson

Wallace

et al. 2014

Australas J Ultrason Med

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Acute flail mitral leaflet is a time‐sensitive, reversible cause of cardiogenic shock. Transthoracic echocardiography (echo) is increasingly becoming a vital tool for non‐cardiologist physicians who treat patients with undifferentiated chest pain and dyspnoea. The sonographic abnormalities seen in acute flail mitral leaflet are within the boundaries of a focused echo. Individually, these findings are non‐specific. As a constellation, however, they are highly suggestive of this disease process. We present a case series of three patients with acute flail mitral leaflet seen on emergency department echo along with a discussion of the findings and the disease itself.

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The underlying causes of chordae tendinae rupture: A systematic review

Cited by 59 publications

References 40 publications

Acute Rupture of Chordae Tendineae of the Mitral Valve in Infants

Acute Rupture of Chordae Tendineae of the Mitral Valve in Infants

An unusual finding of left ventriculography in Marfan syndrome with severe mitral valve prolapse

Three patients with signs of acute flail mitral leaflet seen on emergency department echo: a critical constellation within the focused cardiac exam

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