AI Article Synopsis
- A 21-year-old man with Wolff-Parkinson-White syndrome experienced ventricular fibrillation and required mechanical support, but initially showed no signs of coronary issues.
- After a brief recovery, he was re-intubated due to congestive heart failure; echocardiography indicated severe mitral regurgitation and a mobile mass.
- Emergency surgery revealed a rupture of the posterior papillary muscle, which was repaired, and it was suggested that the rupture was caused by arrhythmia-related issues and septic embolization.
Article Abstract
A 21-year-old man with Wolff-Parkinson-White syndrome presented to the authors' hospital with ventricular fibrillation. Coronary angiography failed to demonstrate coronary stenosis, but temporary mechanical circulatory support resolved the ventricular fibrillation and the patient was extubated eight days later. On the next day, however, he had to be re-intubated with symptoms of congestive heart failure. Echocardiography revealed new severe mitral regurgitation and a mobile mass, while emergency surgery revealed a posteromedial papillary muscle rupture (PMR). The mitral regurgitation was repaired with ruptured papillary muscle relocation, artificial chordae implantation, and ring annuloplasty. Postoperative examinations suggested that an arrhythmia-induced coronary circulation hypoperfusion and septic embolization had caused the PMR.
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