Posterior Chordae Rupture of the Tricuspid Valve due to Myocardial Infarction: A Rare Entity Among Tricuspid Valve Pathologies

Main Article Content

Endri Balla
https://orcid.org/0000-0002-9021-4795
Okay Karslıoğlu
https://orcid.org/0009-0001-7403-4743
Dominique Seri
https://orcid.org/0009-0008-1447-7789
Denizhan Akpınar
https://orcid.org/0009-0008-8712-2698
Ecem Tuğba Yamaç
https://orcid.org/0009-0004-4723-1401
Elshad Mansımzada
https://orcid.org/0009-0009-1095-3861
Hakkı Tankut Akay
Elvin Kesimci
https://orcid.org/0000-0001-8245-4134
Atila Sezgin
https://orcid.org/0000-0002-3933-2219

Abstract

The tricuspid valve is rarely affected by myocardial infarction. The right ventricle has a lower systolic pressure compared to the left ventricle making the papillary muscles of the tricuspid valve more resistant to ischemia. The right coronary artery is the main blood supply to tricuspid papillary muscles, chordae rupture of the tricuspid valve may occur following myocardial infarction. Here, we present a rare case of a 70-year-old male with severe tricuspid regurgitation, a completely occluded right coronary artery (RCA), 70% stenosis of the left main coronary artery (LMCA), and 100% occlusion of the left anterior descending artery (LAD). The patient’s ejection fraction (EF) was reduced to 30%. Treatment included tricuspid valve repair using the bicuspidization technique and a five-vessel coronary artery bypass graft (CABG). This case demonstrates that, although rare, myocardial infarction can involve the tricuspid valve and that the surgery of the valve with full revascularization proved to be an effective treatment strategy in our patient.

Article Details

How to Cite
Balla, E., Karslıoğlu, A. . O., Seri, D., Akpınar , D., Yamaç , E. T., Mansımzada, E., Akay , H. . T., Kesimci, E., & Sezgin , A. (2025). Posterior Chordae Rupture of the Tricuspid Valve due to Myocardial Infarction: A Rare Entity Among Tricuspid Valve Pathologies. Brazilian Journal of Case Reports, 5(1), bjcr64. https://doi.org/10.52600/2763-583X.bjcr.2025.5.1.bjcr64
Section
Clinical Case Reports
Author Biographies

Endri Balla, Cardiovascular Surgery Department, Baskent University Hospital

Cardiovascular Surgery Department, Baskent University Hospital, Ankara, Turkey.

Okay Karslıoğlu, Cardiovascular Surgery Department, Baskent University Hospital

Cardiovascular Surgery Department, Baskent University Hospital, Ankara, Turkey.

Dominique Seri, Anesthesiology Department, Baskent University Hospital

Anesthesiology Department, Baskent University Hospital, Ankara, Turkey.

Denizhan Akpınar , Cardiovascular Surgery Department, Baskent University Hospital

Cardiovascular Surgery Department, Baskent University Hospital, Ankara, Turkey.

Ecem Tuğba Yamaç , Cardiovascular Surgery Department, Baskent University Hospital

Cardiovascular Surgery Department, Baskent University Hospital, Ankara, Turkey.

Elshad Mansımzada, Cardiovascular Surgery Department, Baskent University Hospital

Cardiovascular Surgery Department, Baskent University Hospital, Ankara, Turkey.

Hakkı Tankut Akay , Cardiovascular Surgery Department, Baskent University Hospital

Cardiovascular Surgery Department, Baskent University Hospital, Ankara, Turkey.

Elvin Kesimci, Anesthesiology Department, Baskent University Hospital

Anesthesiology Department, Baskent University Hospital, Ankara, Turkey.

Atila Sezgin , Cardiovascular Surgery Department, Baskent University Hospital

Cardiovascular Surgery Department, Baskent University Hospital, Ankara, Turkey.

References

Kanemitsu S, Sakamoto S, Yamamoto N, Shimpo H. Valve repair for tricuspid papillary muscle rupture late after percutaneous coronary intervention. Eur J Cardiothorac Surg. 2018 Nov;54(5):959-61. doi: 10.1093/ejcts/ezy175.

D'Aloia A, Bonadei I, Vizzardi E, Sciatti E, Bugatti S, Curnis A, Metra M. Different types of tricuspid flail: case reports and review of the literature. Hellenic J Cardiol. 2016 Mar-Apr;57(2):134-7. doi: 10.1016/j.hjc.2016.03.007.

Eisenberg S, Suyemoto J. Rupture of a papillary muscle of the tricuspid valve following acute myocardial infarction: report of a case. Circulation. 1964;30:588-91

Pereira J, Essa M, Sugeng L. Double rupture of a tricuspid papillary muscle and ventricular septum: a rare combination after myocardial infarction. CASE (Phila). 2019 Apr;3(2):85-8.

Gouda P, Weilovitch L, Kanani R, Har B. Case report and review of nonischemic spontaneous papillary muscle rupture reports between 2000 and 2015. Echocardiography. 2017;34:786-90.

Kunhali K, Cherian G, Bakthaviziam A, Abraham MT, Krishnaswami S. Rupture of a papillary muscle of the tricuspid valve in primary pulmonary hypertension. Am Heart J. 1980;99:225-9.

Nagumo M, Saito T, Sakai T, Iwanaga S. Severe tricuspid regurgitation due to papillary muscle rupture: a rare complication of anterior myocardial infarction and ventricular septal perforation. Eur Heart J Case Rep. 2020 Oct 29;4(6):1-3. doi: 10.1093/ehjcr/ytaa341. PMID: 33629006; PMCID: PMC7891262.

Rodes-Cabau J, Taramasso M, O’Gara PT. Diagnosis and treatment of tricuspid valve disease: current and future perspectives. Lancet. 2016;388:2431-42.