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REPAIR OF THE MITRAL VALVE AFTER RUPTURE OF CHORDAE TENDINEAE

Sudden mitral valve incompetence due to ruptured chordæ tendineæ is believed to be more common than was recognized a few years ago. A patient who presents with mitral incompetence, who has a short history, or in whom the condition has had a sudden, definite onset (even presenting as a medical emergency), or who has a well‐documented history of subacute bacterial endocarditis, is very likely to have this condition. A relatively small left atrium, sinus rhythm and the absence of calcification of the valve are additional features of this condition. Such a patient with some of these features, who has any disability, should undergo the appropriate investigations, because surgical correction is likely to restore the mitral valve to normal or near‐normal function before serious permanent damage has been done to the heart.