A neonate with the rupture of mitral chordae tendinae associated with maternal-derived anti-SSA antibody

Acute mitral insufficiency due to the rupture of chordae tendinae from papillary muscles is a rare but sometimes fatal condition in neonates and infants. Here, we report a 21-day-old neonate with sudden onset of mitral insufficiency due to rupture of the chordae tendinae. The baby was successfully rescued by appropriate diagnosis and emergency surgical operation with reconstruction of the ruptured chordae using autologous pericardium-reinforced mattress suture. Intraoperative findings revealed fibrous scar formation at the distal end of the posterior papillary muscle, indicating a remnant of a certain inflammatory reaction. Transplacental passage of maternal anti-SSA antibody could account for the fetal inflammation at the ruptured chordae and the papillary muscle.