Rupture of the posterior wall of the left ventricle after mitral valve replacement.

Rupture of the posterior wall of the left ventricle is an unusual but often lethal complication following mitral valve replacement (MVR). We have encountered it six times with a 100 per cent mortality rate in a series of 1,154 operations for MVR. Sites of rupture were located at the base of the resected papilary muscle or close to the artioventricular groove in the area adjacent to the resected posterior mitral leaflet. T stongly indicates the overzealous resection of the mitral leaflets and papillary muscle as an important eitiologic factor. Other possible etiologic factors are discussed and important pitfalls to be avoided during MVR are stressed.