Papillary muscle rupture following routine aortic valve replacement.

A 56-year-old man who underwent routine aortic valve replacement (AVR) for aortic insufficiency suffered a presumed embolic event to a small vessel supplying the posteromedial papillary muscle. This led to papillary muscle rupture, and severe, acute mitral regurgitation requiring emergent mitral valve replacement 6 days postoperatively. Small-vessel coronary embolization outside the setting of infection/endocarditis leading to infarction and papillary muscle rupture following elective AVR has not been previously described in the literature.