Transesophageal echocardiographic findings of papillary muscle rupture

Sakai, Kichiro; Nakamura, Kenji; Hosoda, Saichi

doi:10.1016/0002-9149(91)90802-r

Cited by 12 publications

(5 citation statements)

References 5 publications

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“…Die Therapie ist ausnahmslos ehirurgiseh, dabei wird iiber eine bilaterale Atriotomie der Tumor mitsamt des basisnahen Vorhofseptums exzidiert. Bei multiplen Myxomen ist eine radikale Entfernung aller Wandanteile anzustreben, urn Rezidive zu verhindern [53].…”

Section: Fibromeunclassified

“…Etwa 80% alIer Perikarddefekte sind partielIe Defekte des linksseitigen parietalen Perikards, die meist mit einem Defekt der benachbarten parietalen Pleura einhergehen. Sie werden dann als pleuro-perikardiale Defekte bezeichnet und fiihren zu einer abnormen Verbindung zwischen Pleurahohle und Cavum peri cardii [8,9,12,23,24,32,41,53]. Diese Verbindung wurde fruher diagnostisch genutzt [53]: Durch Anlegen eines (linksseitigen) Pneumothorax kann mit Auftreten eines Pneumoperikards ein pleuro-perikardialer Defekt naehgewiesen werden.…”

Section: • Kongenitale Perikarddefekteunclassified

“…Sie werden dann als pleuro-perikardiale Defekte bezeichnet und fiihren zu einer abnormen Verbindung zwischen Pleurahohle und Cavum peri cardii [8,9,12,23,24,32,41,53]. Diese Verbindung wurde fruher diagnostisch genutzt [53]: Durch Anlegen eines (linksseitigen) Pneumothorax kann mit Auftreten eines Pneumoperikards ein pleuro-perikardialer Defekt naehgewiesen werden. Diese Untersuchung ist heute nicht mehr indiziert.…”

Section: • Kongenitale Perikarddefekteunclassified

“…Manche werden zufallig bei einer Rontgenthoraxuntersuchung gefunden, die aus anderen Grunden durchgefuhrt wurde. Bei 10000 Autopsien wird ein partieller linksseitiger Perikarddefekt einmal als Zufallsbefund erhoben [53].…”

Section: • Kongenitale Perikarddefekteunclassified

“…Bei kleineren traumatischen Defekten wird konservatives Vorgehen empfohlen, da hierbei Spontanverschlusse beobachtet wurden [22,53,62].…”

Section: Ventrikelseptumdefekte Entstehen Nach Einerunclassified

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Seltenere angeborene und erworbene Anomalien des Herzens

Schmaltz¹,

Apitz²,

Hassberg³

et al. 2002

Pädiatrische Kardiologie

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Section: Fibromeunclassified

Section: • Kongenitale Perikarddefekteunclassified

“…Bei kleineren traumatischen Defekten wird konservatives Vorgehen empfohlen, da hierbei Spontanverschlusse beobachtet wurden [22,53,62].…”

Section: Ventrikelseptumdefekte Entstehen Nach Einerunclassified

See 3 more Smart Citations

Seltenere angeborene und erworbene Anomalien des Herzens

Schmaltz¹,

Apitz²,

Hassberg³

et al. 2002

Pädiatrische Kardiologie

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Diagnosis of papillary muscle rupture after acute myocardial infarction by transthoracic and transesophageal echocardiography

Dohmen

Genth

et al. 1993

Clinical Cardiology

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Summary:The sensitivity of transthoracic echocardiography to visualize the structural abnormality of papillary muscle rup ture (PMR) after acute myocardial infarction can be anticipated to average about 50%; therefore, we evaluated five patients exhibiting the condition with both transthoracic and transesophageal echocardiography. The use of the two imaging techniques resulted in the fact that no instance of PMR was missed. Using transthoracic echocardiography in two patients and transesophageal echocardiography in four, the ruptured papillary muscle was visualized directly. Mitral insufficiency as an indirect sign was observed in all patients. In one patient the papillary muscle rupture developed in a mitral valve previously affected by endocarditis. All patients underwent mitral valve replacement and coronary artery bypass grafting. The diagnosis was confirmed at surgery in all patients. Four patients died in hospital, the fifth 5 months later. We recommend that transesophageal echocardiography be performed in patients with suspected PMR if transthoracic echocardiography does not provide an unequivocal diagnosis.Key words: papillary muscle rupture, myocardial infarction, echocardiography, transesophageal echocardiography IntmductionThe incidence of papillary muscle rupture (PMR) in acute myocardial infarction is found to be 0.9%,' and averages up to 5% in fatal myocardial infarctions? This complication can de-*This paper contains parts of the doctoral thesis of Guido Dohmen.

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The vital role of papillary muscles in mitral and ventricular function: echocardiographic insights

Madu

D’Cruz

1997

Clinical Cardiology

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Summary:The two left ventricular (LV) papillary muscles are small structures but are vital to mitral valve competence. Partial or complete rupture, complicating acute myocardial infarction, causes severe or even catastrophic mitral regurgitation, potentially correctable by surgery. Papillary muscle dysfunction is a controversial topic in that the role of the papillary muscle itself, in causing mitral regurgitation post infarction, has been seriously questioned; it is less confusing if this syndrome is attributed not only to papillary muscle but also to adjacent LV wall ischemia or infarction. Papillary muscle calcification is easily and frequently detected on echocardiogrdphy, but its clinical significance remains uncertain. Papillary muscle hypertrophy accompanies LV hypertrophy of varied etiology and may have a significant role in producing dynamic late-systolic intra-LV obstruction in hypertrophic cardiomyopathy and other hyperdynamic hypertrophied LV chambers. All the above abnormalities can be adequately assessed by 2-D echocardiography and the Doppler modalities. In selected cases, transesophageal echocardiography can provide additional valuable data by improving visualization of papillary muscles and mitral apparatus.

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Transesophageal echocardiographic findings of papillary muscle rupture

Cited by 12 publications

References 5 publications

Seltenere angeborene und erworbene Anomalien des Herzens

Seltenere angeborene und erworbene Anomalien des Herzens

Diagnosis of papillary muscle rupture after acute myocardial infarction by transthoracic and transesophageal echocardiography

The vital role of papillary muscles in mitral and ventricular function: echocardiographic insights

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