Disrupción auriculoventricular posterior a reoperación de reemplazo valvular mitral: reparación y evaluación ecocardiográfica

Atrioventricular disruption after a mitral valve replacement is a rare but fatal complication. A case of 72 year-old woman is presented. She had a medical history of aortic and mitral valve replacement and Maze and tricuspid valve surgery. Mitral valve replacement was performed with Hancock 29 mitral prosthesis. She was taken to ICU and postoperative progress was normal until 24 hours after the surgery, when she developed dyspnea and required inotropic support. A CT angiography and transthoracic echocardiogram were performed, which evidence a ventricular pseudoaneurysm. She was taken to the operating room to start extracorporeal circulation. Atrioventricular disruption was evidenced in the posterior mitral annulus (type I perforation). Rupture was closed with a using a mixed Dacron and bovine pericardial patch with continuous suture. Patient is currently in good condition with no recurrence. Case, etiology, surgical repair and prevention of this rare complication were investigated and discussed.