Author + information
- Received September 7, 1982
- Revision received October 25, 1982
- Accepted October 29, 1982
- Published online April 1, 1983.
- Marc K. Effron, MD*
- ↵*Address for reprints: Marc K. Effron, MD, Cardiology Division C-248, Stanford Medical Center, Stanford, California 94305.
Ten patients with aortic stenosis and ruptured mitral chordae tendineae constituted 8% of 125 consecutive surgical cases of chordal rupture. Their ages ranged from 54 to 87 years (mean 68). Six patients presented with acute onset of congestive heart failure, and eight were in New York Heart Association functional class HI or IV at the time of cardiac catheterization. Extensive mitral anulus calcification was observed by fluoroscopy in seven patients. The mean aortic valve area index was 0.4 cm2/m2and nine patients had moderate to severe mitral regurgitation by angiography. Calcific aortic stenosis affected a tricuspid valve in nine cases and a bicuspid valve in one case. One patient had a rheumatic mitral valve and one a redundant myxomatous mitral valve; the remaining eight had no abnormality of the mitral apparatus commonly regarded as predisposing to chordal rupture. Mitral anulus calcification and ventricular anatomic and hemodynamic alterations in aortic stenosis may contribute to rupture of the mitral chordae tendineae.
- Received September 7, 1982.
- Revision received October 25, 1982.
- Accepted October 29, 1982.
- American College of Cardiology Foundation