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We report nine patients with acute mitral regurgitation secondary to post-infarction papillary rupture operated between 1980 and 1992. Seven cases had posterior papillary muscle rupture. All patients were in critical conditions with pulmonary edema at the moment of surgery. In eight cases, mitral valve replacement was performed (4 with mechanical prostheses) and in one, the valve was repaired with papillary muscle reimplantation. Six cases were also subjected to myocardial revascularization with sapheneous vein grafts. Two patients (22%) died during the postoperative period and 4 had postoperative complications. The seven survivors have been followed during 6 to 115 month. Of theses, one died six month after surgery due to congestive heart failure, three are in functional class I and the rest in functional class II. It is concluded that, although mitral valve replacement for papillary muscle rupture has a high operative mortality and morbidity, long term results are satisfactory.
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