Postinfarction double papillary muscle rupture in three surgically excised mitral valves

Three patients ranging in age from 58 to 72 years underwent mitral valve replacement for cardiogenic shock and severe mitral insufficiency associated with acute myocardial infarction. Correlation of the gross and microscopic findings confirmed the presence of partial rupture of both papillary muscles in all three cases. Papillary muscle rupture is an infrequent complication of acute myocardial infarction; double papillary muscle rupture an extreme rarity, previously only reported at autopsy. To our knowledge, the occurrence of postinfarction dual papillary muscle rupture in surgically excised valves has not been previously reported in the literature.