Atrioventricular Disruption

Abstract

Atrioventricular groove disruption is a rare but frequently lethal complication of mitral valve replacement. Factors resulting in a fragile myocardium coupled with operative trauma appear to precipitate an incipient rupture. The best repair strategy, “internal” vs. “external,” remains undefined and generally the clinical circumstance dictates the operative strategy. Complete cardiac decompression is critical for a good outcome. Repair attempts without cardiopulmonary bypass risk propagation of injury and should not be pursued. This chapter provides an overview of atrioventricular disruption.