Redo mitral valve replacement using valve-on-valve technique in a patient with severe posterior mitral annular calcification

Redo mitral valve replacement surgery due to bioprosthetic valve failure can carry serious surgical challenges. In addition to the usual redo sternotomy risk, there is risk of circumflex coronary artery injury or atrioventricular disruption from explanting the prosthesis. Alternatives to prosthesis...

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Published inBMJ case reports Vol. 14; no. 7; p. e243527
Main Authors Al Kindi, Adil H, Mandisha, Ahmed Fahmy, Hammam, Mohamed, Salem, AbdelMaged
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 21.07.2021
BMJ Publishing Group
Subjects
Ascites
Bioprosthesis - adverse effects
Calcification
Case Report
Case reports
Edema
Heart surgery
Heart Valve Diseases - surgery
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Humans
Medical diagnosis
Medical imaging
Mitral Valve - diagnostic imaging
Mitral Valve - surgery
Mortality
Patients
Prostheses
Prosthesis Failure
Pulmonary arteries
Reoperation
Surgical outcomes
Sutures
Treatment Outcome
Ultrasonic imaging
Veins & arteries
United States > US
clinical diagnostic tests
surgical diagnostic tests
valvar diseases
radiology
radiology (diagnostics)
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Summary:Redo mitral valve replacement surgery due to bioprosthetic valve failure can carry serious surgical challenges. In addition to the usual redo sternotomy risk, there is risk of circumflex coronary artery injury or atrioventricular disruption from explanting the prosthesis. Alternatives to prosthesis explantation may be needed in some cases.We report a case of mitral bioprosthetic valve failure in a young patient who had a history of atrioventricular disruption during the first surgery and had pericardial patch repair of the defect. The risk of explanting the bioprosthesis during redo surgery was very high. Therefore, we performed valve replacement using valve-on-valve technique in which the new valve is implanted within the sewing ring of the previous bioprosthesis without explanting the valve. This technique converted a very highly futile surgery to a conventional redo surgery risk. The patient had a successful surgery with no intraoperative or postoperative complications.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
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ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2021-243527