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Late Presentation of Recurrent Monomorphic Ventricular Tachycardia following Minimally Invasive Mitral Valve Repair due to Epicardial Injury.

South HL, Osoro M, Overly T - Case Rep Cardiol (2014)

Bottom Line: We report a 73-year-old male with late onset monomorphic ventricular tachycardia following mitral valve repair (MVR).Typically, injury to epicardial arteries following mitral valve repair/replacement presents immediately as ventricular tachycardia/fibrillation, difficulty weaning from cardiopulmonary bypass, worsening ECG changes, increasing cardiac biomarkers, or new wall motion abnormalities.Our case illustrates a "late complication" of a distorted circumflex artery following mitral valve repair and the importance of early diagnostic angiography and percutaneous intervention.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Division of Cardiology, Graduate School of Medicine, University of Tennessee, Knoxville, TN 37920, USA.

ABSTRACT
We report a 73-year-old male with late onset monomorphic ventricular tachycardia following mitral valve repair (MVR). Typically, injury to epicardial arteries following mitral valve repair/replacement presents immediately as ventricular tachycardia/fibrillation, difficulty weaning from cardiopulmonary bypass, worsening ECG changes, increasing cardiac biomarkers, or new wall motion abnormalities. Our case illustrates a "late complication" of a distorted circumflex artery following mitral valve repair and the importance of early diagnostic angiography and percutaneous intervention.

No MeSH data available.


Related in: MedlinePlus

Kinked circumflex artery (arrow) secondary to suture distortion from a recently repaired mitral valve. Left anterior oblique with caudal angulation.
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fig1: Kinked circumflex artery (arrow) secondary to suture distortion from a recently repaired mitral valve. Left anterior oblique with caudal angulation.

Mentions: The patient was taken to the cardiac catheterization lab on postoperative day 11 for left cardiac catheterization which revealed tenting of the mid circumflex artery, with 99% stenosis and TIMI grade I flow distally (Figure 1) and normal left ventricular ejection fraction. A 2.25 mm bare metal stent was placed within the mid circumflex with excellent angiographic results and TIMI grade III flow distally after the intervention (Figure 2). The patient was started on dual antiplatelet therapy and was discharged in sinus rhythm and stable condition on postoperative day 12. The patient was in stable condition during a 4 month followup and interrogation of the ICD revealed one episode of ventricular tachycardia that was successfully treated (shock therapy).


Late Presentation of Recurrent Monomorphic Ventricular Tachycardia following Minimally Invasive Mitral Valve Repair due to Epicardial Injury.

South HL, Osoro M, Overly T - Case Rep Cardiol (2014)

Kinked circumflex artery (arrow) secondary to suture distortion from a recently repaired mitral valve. Left anterior oblique with caudal angulation.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4008277&req=5

fig1: Kinked circumflex artery (arrow) secondary to suture distortion from a recently repaired mitral valve. Left anterior oblique with caudal angulation.
Mentions: The patient was taken to the cardiac catheterization lab on postoperative day 11 for left cardiac catheterization which revealed tenting of the mid circumflex artery, with 99% stenosis and TIMI grade I flow distally (Figure 1) and normal left ventricular ejection fraction. A 2.25 mm bare metal stent was placed within the mid circumflex with excellent angiographic results and TIMI grade III flow distally after the intervention (Figure 2). The patient was started on dual antiplatelet therapy and was discharged in sinus rhythm and stable condition on postoperative day 12. The patient was in stable condition during a 4 month followup and interrogation of the ICD revealed one episode of ventricular tachycardia that was successfully treated (shock therapy).

Bottom Line: We report a 73-year-old male with late onset monomorphic ventricular tachycardia following mitral valve repair (MVR).Typically, injury to epicardial arteries following mitral valve repair/replacement presents immediately as ventricular tachycardia/fibrillation, difficulty weaning from cardiopulmonary bypass, worsening ECG changes, increasing cardiac biomarkers, or new wall motion abnormalities.Our case illustrates a "late complication" of a distorted circumflex artery following mitral valve repair and the importance of early diagnostic angiography and percutaneous intervention.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Division of Cardiology, Graduate School of Medicine, University of Tennessee, Knoxville, TN 37920, USA.

ABSTRACT
We report a 73-year-old male with late onset monomorphic ventricular tachycardia following mitral valve repair (MVR). Typically, injury to epicardial arteries following mitral valve repair/replacement presents immediately as ventricular tachycardia/fibrillation, difficulty weaning from cardiopulmonary bypass, worsening ECG changes, increasing cardiac biomarkers, or new wall motion abnormalities. Our case illustrates a "late complication" of a distorted circumflex artery following mitral valve repair and the importance of early diagnostic angiography and percutaneous intervention.

No MeSH data available.


Related in: MedlinePlus