• A&A practice · Mar 2021

    Case Reports

    A Case Report on Papillary Muscle Rupture Following Mitral Valve Replacement in the Setting of Previously Undiagnosed Amyloidosis.

    • Nadim Choudhury, Ronny Munoz Acuna, Omar Chaudhary, Louis Chu, Paul VanderLaan, Feroze Mahmood, and Aidan Sharkey.
    • From the Department of Anesthesia, Critical Care and Pain Medicine.
    • A A Pract. 2021 Mar 8; 15 (3): e01415.

    AbstractThis case describes a patient who underwent mitral valve replacement (MVR) surgery with preservation of the subvalvular apparatus who suffered anterolateral papillary muscle rupture (PMR) postseparation from cardiopulmonary bypass. This patient had no history of coronary artery disease (CAD); subsequent pathology of the papillary muscle showed evidence of amyloid deposition. Although most PMRs are caused by ischemia from CAD, cardiac amyloidosis must be considered in the absence of CAD and worked up appropriately as cardiac involvement of amyloidosis, especially the amyloid light-chain (AL) subtype, is prognostic of increased mortality that can be mitigated with therapy.Copyright © 2021 International Anesthesia Research Society.

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