{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:34:14Z","timestamp":1792096454864,"version":"4.4.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,10,31]],"date-time":"2021-10-31T00:00:00Z","timestamp":1635638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,24]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>\u2002<\/jats:title><\/jats:sec><jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>Papillary muscle rupture (PMR) is a rare but potentially fatal complication of acute myocardial infarction. The aim of this study was to analyse the patient characteristics and early outcomes of the surgical management of post-infarction PMR from an international multicentre registry.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Patients underwent surgery for post-infarction PMR between 2001 through 2019 were retrieved from database of the CAUTION study. The primary end point was in-hospital mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 214 patients were included with a mean age of 66.9 (standard deviation: 10.5) years. The posteromedial papillary muscle was the most frequent rupture location (71.9%); the rupture was complete in 67.3% of patients. Mitral valve replacement was performed in 82.7% of cases. One hundred twenty-two patients (57%) had concomitant coronary artery bypass grafting. In-hospital mortality was 24.8%. Temporal trends revealed no apparent improvement in in-hospital mortality during the study period. Multivariable analysis showed that preoperative chronic kidney disfunction [odds ratio (OR): 2.62, 95% confidence interval (CI): 1.07\u20136.45, P\u2009=\u20090.036], cardiac arrest (OR: 3.99, 95% CI: 1.02\u201315.61, P\u2009=\u20090.046) and cardiopulmonary bypass duration (OR: 1.01, 95% CI: 1.00\u20131.02, P\u2009=\u20090.04) were independently associated with an increased risk of in-hospital death, whereas concomitant coronary artery bypass grafting was identified as an independent predictor of early survival (OR: 0.38, 95% CI: 0.16\u20130.92, P\u2009=\u20090.031).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Surgical treatment for post-infarction PMR carries a high in-hospital mortality rate, which did not improve during the study period. Because concomitant coronary artery bypass grafting confers a survival benefit, this additional procedure should be performed, whenever possible, in an attempt to improve the outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p>clinicaltrials.gov: NCT03848429.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ejcts\/ezab469","type":"journal-article","created":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T23:53:37Z","timestamp":1634342017000},"page":"469-476","source":"Crossref","is-referenced-by-count":24,"title":["Surgical treatment for post-infarction papillary muscle rupture: a multicentre study"],"prefix":"10.1093","volume":"61","author":[{"given":"Giulio","family":"Massimi","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, 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of Udine, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3473-1779","authenticated-orcid":false,"given":"Igor","family":"Vendramin","sequence":"additional","affiliation":[{"name":"Cardiothoracic Department, University Hospital of Udine, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giosu\u00e8","family":"Falcetta","sequence":"additional","affiliation":[{"name":"Section of Cardiac Surgery, University Hospital, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9781-3590","authenticated-orcid":false,"given":"Theodor","family":"Fischlein","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Cardiovascular Center, Klinikum N\u00fcrnberg, Paracelsus Medical University, Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Troise","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, Poliambulanza Foundation Hospital, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2410-3218","authenticated-orcid":false,"given":"Cinzia","family":"Trumello","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery Department, San Raffaele University Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4209-2866","authenticated-orcid":false,"given":"Guglielmo","family":"Actis Dato","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Mauriziano Hospital, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5506-0201","authenticated-orcid":false,"given":"Massimiliano","family":"Carrozzini","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, Cardio-Thoraco-Vascular Department, Niguarda Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shabir Hussain","family":"Shah","sequence":"additional","affiliation":[{"name":"Cardiovascular and Thoracic Surgery Department, King Fahad Medical City, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria Lo","family":"Coco","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3446-7832","authenticated-orcid":false,"given":"Emmanuel","family":"Villa","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, Poliambulanza Foundation Hospital, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Scrofani","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, Luigi Sacco Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Torchio","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Antona","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, Luigi Sacco Hospital, Milan, 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Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Thielmann","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center, University of Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8110-4009","authenticated-orcid":false,"given":"Bart","family":"Meyns","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6772-8034","authenticated-orcid":false,"given":"Fareed A","family":"Khouqeer","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi 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