Papillary muscle rupture following myocardial infarction.

A patient is reported in whom rupture of the posterior papillary muscle of the left ventricle occurred following myocardial infarction. The intractable pulmonary oedema that followed responded to the combined surgical approach of mitral valve replacement, resection of the akinetic area of the left ventricular wall, and saphenous vein aortocoronary bypass. This combination of surgical procedures has not been reported to date, and was considered to have preserved adequate left ventricular performance.