Abstract
When acute severe mitral regurgitation is associated with pulmonary edema in the immediate period after myocardial infarction, the patient must be treated aggressively. Because the papillary muscles are perfused by the terminal portion of the coronary vascular bed, they are particularly vulnerable to ischemia and any disturbance in coronary perfusion such as an acute occlusion of a coronary artery may result in papillary muscle dysfunction [1]. When the ischemia is severe and persistent, papillary muscle necrosis and permanent mitral regurgitation may result. The posterior papillary muscle is supplied by the posterior descending branch of the right coronary artery and is infarcted more frequently than the anterolateral papillary muscle, which is supplied by diagonal branches of the left anterior descending artery and often by the marginal branches of the circumflex coronary artery [2]. Reperfusion therapy with fibrinolytic agents or coronary angioplasty theoretically could salvage the functional integrity of the mitral valve apparatus without surgery.
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References
Estes EH Jr, Dalton FM, Entman ML, Dixon HB, Hackel DB (1966) The anatomy and blood supply of the papillary muscles of the left ventricle. Am Heart J 1:356–362
Braunwald E (1984) Valvular heart disease. In: Braunwald E (ed) Heart disease: a textbook of cardiovascular medicine. 2nd ed. Saunders, Philadelphia, pp 1076–1078
Heuser RR, Maddoux GL, Goss JE, Ramo BW, Raff GL, Shadoff N (1987) Coronary angioplasty for acute mitral regurgitation due to myocardial infarction. Ann Int Med 107:852–855
Fuchs RM, Heuser RR, Yin FCP, Brinker JA (1982) Limitations of pulmonary wedge V waves in diagnosing mitral regurgitation. Am J Cardiol 49:849–854
Reinfeld HB, Samet P, Hildner JF (1985) Resolution of congestive failure, mitral regurgitation and angina after percutaneous transluminal coronary angioplasty of triple vessel disease. CathCVDiag 11:273–277
Gahl K, Sutton R, Pearson M, Caspari P, Lairet A, McDonald L (1977) Mitral regurgitation in coronary heart disease. Br Heart J 39:13–18
Vlodaver Z, Edwards JE (1977) Rupture of ventricular septum or papillary muscle complicating myocardial infarction. Circulation 55:815–822
Tepe NA, Edmunds LH (1985) Operation for acute postinfarction mitral insufficiency and cardiogenic shock. J Thorac Cardiovasc Surg 89:525–530
Wei JY, Hutchins GM, Bulkley BH (1979) Papillary muscle rupture in a fatal acute myocardial infarction. A potentially treatable form of cardiogenic shock. Ann Intern Med 90:149–153
Pinson CW, Cobanoglu A, Metzdorff MT, Grunkemeier GL, Kay PH, Starr A (1984) Late surgical results for ischemic mitral regurgitation: role of wall motion score and severity of regurgitation. J Thorac Cardiovascular Surg 88:663–672
Gruppo Italiano per lo studio della streptochinasi neh” infarcto miocardico (GISSI) (1986) Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1:397–401
Van de Werf F et al. (1988) Lessons from the European cooperative recombinant tissue-type plasminogen activator (rt-PA) versus placebo trial. J Am Coll Cardiol 12:14A—19A
Rapaport E (1989) Thrombolytic agents in acute myocardial infarction. N Engl J Med 13:861–864
Mark DB, Hlatky M, O’Connor CM, Pryor DB, Wall TC, Honan MB, Phillips III HR, Califf RM (1988) Administration of thrombolytic therapy in the community hospital: Established principles and unresolved issues. J Am Coll Cardiol 12:32A—43A
Hartzler GO, Rutherford BD, McConahay DR, et al. (1983) Coronary angioplasty with and without thrombolytic therapy for treatment of acute myocardial infarction. Am Heart J 106:965–973
Pepine CJ, Prida X, Hill JA, Feldman RL, Conti CR (1984) Coronary angioplasty in acute myocardial infarction. Am Heart J 107:820–822
Shani J, Rivera M, Greengart A, Hollander G, Kaplan P, Lichstein E (1986) Coronary angioplasty in cardiogenic shock (abstract). J Am Coll Cardiol 7:149A
Heuser RR, Maddoux GL, Goss JE, Ramo BW, Raff GL, Shadoff N (1986) Coronary angioplasty in the treatment of cardiogenic shock: the therapy of choice (abstract). J Am Coll Cardiol 7:219A
Bates ER, Califf RM, Stack RS, Aronson L, George BS, Candela RJ, Kereiakes DJ, Abbottsmith CW, Anderson L, Pitt B, O’Neill WW, Topol EJ, TIMI group (1989) Thrombolysis and angioplasty in myocardial infarction (TAMI-1) trial: Influence of infarct location on arterial patency, left ventricular function and mortality. J Am Coll Cardiol 13:12–18
Selzer A (1989) Does thrombolytic therapy reduce infarct size? J Am Coll Cardiol 13:1431–1434
Faxon DP (1988) The risk of reperfusion strategies in the treatment of patients with acute myocardial infarction. J Am Coll Cardiol 12:52A-57A
De Bono DP (1988) The European Cooperative Study Group trial of intravenous recombinant tissue-type plasminogen activator (rt-PA) and conservative therapy versus rt-PA and immediate coronary angioplasty. J Am Coll Cardiol. 1988; 12:20A—23A
Braunwald E (1988) Thrombolytic reperfusion of acute myocardial infarction: resolved and unresolved issues. J Am Coll Cardiol 12:85A-92A
TIMI Study Group (1989) Comparison of invasive and conservative strategies after treatment with intravenous tissue plasminogen activator in acute myocardial infarction. N Engl J Med 320:618–627
TIMI Study Group (1985) The thrombolysis in myocardial infarction (TIMI) trial. Phase I Findings. N Engl J Med 312:932–936
Topol EJ, Weiss JL, Brinker JA, et al. (1985) Regional wall motion improvement after coronary thrombolysis with recombinant tissue plasminogen activator: importance of coronary angioplasty. J Am Coll Cardiol 6:426–433
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© 1991 Springer-Verlag Berlin Heidelberg
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Heuser, R.R. (1991). Coronary angioplasty for acute mitral regurgitation due to myocardial infarction. In: Vetter, H.O., Hetzer, R., Schmutzler, H. (eds) Ischemic Mitral Incompetence. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-662-08027-6_9
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DOI: https://doi.org/10.1007/978-3-662-08027-6_9
Publisher Name: Steinkopff, Heidelberg
Print ISBN: 978-3-662-08029-0
Online ISBN: 978-3-662-08027-6
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