Left ventricular rupture resulting from atrial laceration following translocation mitral valve replacement

Translocation mitral valve replacement by anchoring to the left atrial wall instead of the mitral annulus is sometimes performed, but the fragility of the atrial wall is a concern. We report on a patient who suffered a left atrial laceration leading to left ventricular rupture after translocation mitral valve replacement. A surge of hypertension may have predisposed the patient to the laceration of the fragile left atrial wall followed by a ventricular rupture and compromised hemodynamic state.