Abstract
This report describes six previously healthy infants with acute mitral valve chordal rupture. Although their initial symptoms were mild respiratory distress and fever, all the infants presented with acute progressive left heart failure and required urgent surgical repair. Mitral valve annuloplasty and mitral valve replacement were performed (for three patients each). Two patients died, both of whom had cardiac arrest and required resuscitation before surgery. Histologic examination of excised mitral valve leaflets showed infiltration of gram-positive bacteria in these two patients. All the patients were 4–6 months old, which may suggest underlying congenital factors. The authors believe early diagnosis and surgery are crucial as a life-saving measure for infants with acute mitral valve chordal rupture.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Anagnostopoulos P, Alphonso N, Nolke L et al (2007) Neonatal mitral and tricuspid valve repair for in utero papillary muscle rupture. Ann Thorac Surg 83:1458–1462
Baird CW, Constantinos C (2007) Mitral valve chordal rupture masquerades as endocarditis. Pediatr Cardiol 28:297–299
de Moor MM, Lachman PI, Human DG (1986) Rupture of tendinous chords during acute rheumatic carditis in young children. Int J Cardiol 12:353–357
Grinberg AR, Finkielman JD (1998) Rupture of mitral chorda tendinae following blunt chest trauma. Clin Cardiol 21:300–301
Hamaoka A, Shiraishi I (2009) A neonate with the rupture of mitral chordae tendinae associated with maternal-derived anti-SSA antibody. Eur J Pediatr 168:741–743
Juang JJ, Ke SR (2009) Rupture of mitral chordae tendineae: adding to the list of hypertension. Heart 95:976–979
Lessana A, Romano M, Lutfalla G et al (1988) Treatment of ruptured or elongated anterior mitral valve chordae by partial transposition of the posterior leaflet: experience with 29 patients. Ann Thorac Surg 45:404–408
Minami K, Kado H, Sai S et al (2005) Midterm results of mitral valve repair with artificial chordae in children. J Thorac Cardvasc Surg 129:336–342
Mishima A, Asano M, Saito T et al (1996) Mitral regurgitation caused by ruptured chordae tendinae in Kawasaki disease. J Thorac Cardiovasc Surg 111:895–896
Nishi H, Mitsuno M (2008) Severe mitral regurgitation due to cardiac amyloidosis: a rare reason for ruptured chordae. Interact Cardiovasc Thorac Surg 7:1199–1200
Spencer FC, Colvin SB, Culliford AR et al (1985) Experiences with the carpentier techniques of mitral valve reconstruction in 103 patients. J Thorac Cardiovasc Surg 90:341–350
Tamura K, Sugisaki Y, Ogawa S et al (2003) Tumorous deformity of mitral valve leaflet after chordal rupture in a child. Pathol Int 53:51–57
Weidenbach M, Brenner R, Rantamaki T et al (1999) Acute mitral regurgitation due to chordal rupture in a patient with neonatal Marfan syndrome caused by a deletion in exon 29 of the FBN1 gene. Pediatr Cardiol 20:382–385
Acknowledgment
This study was supported by a grant provided by the Ministry of Health, Labour and Welfare, Japan (H22-Nanchi-Ippan-031).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Asakai, H., Kaneko, Y., Kaneko, M. et al. Acute Progressive Mitral Regurgitation Resulting From Chordal Rupture in Infants. Pediatr Cardiol 32, 634–638 (2011). https://doi.org/10.1007/s00246-011-9939-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00246-011-9939-2