Delayed rupture of the left ventricle after mitral valve replacement with bioprosthesis.

Rupture of the posterior ventricular wall after mitral valve replacement is a complication rarely reported in the literature. Perforation of the left ventricle after mitral valve replacement with a bioprosthesis has been described in only 3 patients. We have had 2 patients with this complication out of 322 patients who had mitral valve replacement with bioprosthesis. These perforations were caused by impingement of the posterior strut of the bioprosthesis on the posterior left ventricular wall, with intramyocardial hematoma and delayed rupture of the left ventricle.