A single papillary muscle with chordal rupture in an adult.

A single papillary muscle (SPM) is a rare anomaly in normal adults. It is sometimes associated with a complete common atrioventricular canal. Chordal rupture combined with a single papillary muscle in an adult has not been reported. We repaired the mitral valve with chordal replacement, although this was technically difficult, because the decision to place an artificial chordal attachment on the papillary muscle plays an important role. This report presents successful chordal replacement and band annuloplasty in a case of chordal rupture with a single papillary muscle. A surgical tip for chordal replacement with a single papillary muscle is to suture artificial chords on the same side of the SPM head as the affected side of the mitral valve, considering the direction of pull of the artificial chords.