Experience in mitral valve replacement in the early post-infarction period in a patient with ST-segment elevation myocardial infarction

Abstract

Acute ischemic mitral insufficiency is a serious and life-threatening complication of acute myocardial infarction (MI). The development of acute mitral insufficiency (AMI) severely limits the possibilities of conservative therapy and most often requires emergency surgical intervention. However, the timing and choice of surgical intervention in patients with AMI are debatable. We present a clinical case of AMI development in a 50-year-old patient with inferior MI with late medical care. Given the ineffectiveness of conservative treatment and the progress of acute heart failure, it was decided to perform mitral valve replacement under conditions of cardiopulmonary bypass on the 12th day of MI with the preliminary use of a circulatory assist device (ECMO) as a “bridge” therapy. The presented clinical case confirms that the use of auxiliary blood circulation devices allows expanding the possibilities of cardiac surgical treatment in the early post-infarction period in patients with mechanical ruptures of the heart and reduces the risk of fatal outcomes.