Ventricular Perforation During Open Surgical Balloon Expandable Mitral Valve Replacement: A Case Report

A A Case Rep. 2017 Nov 15;9(10):300-304. doi: 10.1213/XAA.0000000000000599.


A 79-year-old woman with severe mitral annular calcification was scheduled for mitral valve replacement. A SAPIEN 3 valve was implanted in mitral position using an open surgical approach. Immediately after cardiopulmonary bypass, bleeding from an unidentified source was encountered. Cardiopulmonary bypass was emergently resumed and a laceration of the left ventricular apex due to the valve delivery system was detected. Risk factors specific to the open surgical approach include a decompressed ventricle, decreased annulus to apical distance, and the absence of continuous fluoroscopic and echocardiographic imaging. These create a clinical scenario where risk of ventricular perforation is increased compared with traditional intravascular transcatheter valve delivery.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cardiopulmonary Bypass
  • Female
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Heart Ventricles / injuries*
  • Hemorrhage / etiology
  • Humans
  • Mitral Valve / surgery*