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Emergency mitral valve replacement for acute severe mitral regurgitation following balloon mitral valvotomy: pathophysiology of hemodynamic collapse and peri-operative management issues



Emergency mitral valve replacement for acute severe mitral regurgitation following balloon mitral valvotomy: pathophysiology of hemodynamic collapse and peri-operative management issues



Annals of Cardiac Anaesthesia 17(1): 52-55



Severe mitral regurgitation (MR) following balloon mitral valvotomy (BMV) needing emergent mitral valve replacement is a rare complication. The unrelieved mitral stenosis is compounded by severe MR leading to acute rise in pulmonary hypertension and right ventricular afterload, decreased coronary perfusion, ischemia and right ventricular failure. Associated septal shift and falling left ventricular preload leads to a vicious cycle of myocardial ischemia and hemodynamic collapse and needs to be addressed emergently before the onset of end organ damage. In this report, we describe the pathophysiology of hemodynamic collapse and peri-operative management issues in a case of mitral valve replacement for acute severe MR following BMV.

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Accession: 052943979

Download citation: RISBibTeXText

PMID: 24401304

DOI: 10.4103/0971-9784.124143


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