Usefulness and Safety of Rivaroxaban in Patients Following Isolated Mitral Valve Replacement With a Mechanical Prosthesis

Background. Mitral valve replacement can be very difficult to obtain in infants because the valve annulus diameter can be smaller than the available prosthesis.Case Report. We describe the case of a 2-month-old female weighing 3.5 kg affected by mitral valve dysplasia leading to severe valve stenosis. Despite full medication, the clinical conditions were critical and surgery was undertaken. The mitral valve was unsuitable for repair and the orifice of mitral anulus was 12 mm, too small for a mechanical prosthesis. Therefore, a Ross-Kabbani operation was undertaken, replacing the mitral valve with the pulmonary autograft and reconstructing the right ventricular outflow tract with an etherograft.Results. The postoperative course was uneventful and the clinical conditions are good at 4-month follow-up.Conclusion. The Ross-Kabbani operation can be an interesting alternative to mitral valve replacement in infants when valve repair is not achievable and there is little space for an intra-annular mechanical prosthesis implant.

Download Full-text

Early and late stroke after mitral valve replacement with a mechanical prosthesis: risk factor analysis of a 24-year experience

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/s0022-5223(03)00550-6 ◽

2003 ◽

Vol 126 (2) ◽

pp. 358-363 ◽

Cited By ~ 92

Author(s):

Ko Bando ◽

Junjiro Kobayashi ◽

Mitsuhiro Hirata ◽

Toshihiko Satoh ◽

Kazuo Niwaya ◽

...

Keyword(s):

Factor Analysis ◽

Risk Factor ◽

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Risk Factor Analysis ◽

Mechanical Prosthesis

Download Full-text

Early outcomes of mitral valve replacement with a mechanical prosthesis for rheumatic mitral valve disease.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.10.5888 ◽

2020 ◽

Vol 27 (10) ◽

pp. 2266-2270

Author(s):

Musfireh Siddiqeh ◽

Imran Khan ◽

Zainab Farid ◽

Fakhar e Fayyaz ◽

Qudsia Anjum

Keyword(s):

Mitral Valve ◽

Pressure Gradient ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Tricuspid Valve ◽

Valvular Disease ◽

Mechanical Prosthesis ◽

Study Results ◽

The Mean ◽

Valve Pressure

Objectives: To study the early outcomes of mitral valve replacement with a mechanical prosthesis is patients with rheumatic mitral valvular disease. Study Design: Retrospective Observational study. Setting: Punjab Institute of Cardiology, Lahore and Rawalpindi Institute of Cardiology, Rawalpindi. Period: From August 2014 to August 2017. Material & Methods: Consecutive patients who underwent mitral valve replacement for a rheumatic pathology were included in the study. Patients undergoing a redo surgery, those with concomitant aortic valve intervention, coronary artery bypass grafting and emergency procedures were excluded from the study. Results: Of the 104 patients included in the study, 58 (56.2%) were female patients. The mean age of the patients was 35 ± 12.36 years (median 33 years). Sixty (58.5%) had hypertension and 22 (21.28%) had diabetes. Mitral valve stenosis was the main pathology in 84 (81.25%). Severe pulmonary hypertension was recorded in 15 (15%) patients. The mean preoperative Tricuspid Valve Pressure Gradient (TVPG) was 55.33 ± 18.35 mmHg. The mean cross clamp time was 45.33 ± 12.32 minutes. The postoperative tricuspid valve pressure gradient came down to 31.5 ± 12.21 mmHg. No patients had acute renal injury, pulmonary complications or re-exploration for bleeding. Perioperative mortality was 4 (3.75%). Conclusion: Rheumatic valvular disease is still prevalent in our part of the world. Most of the patients with rheumatic heart disease will end up with replacement of the valve. Replacement with a mechanical prosthesis has favorable early outcomes.

Download Full-text

Six-Year Experience with CarboMedics Prosthetic Heart Valves

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849239600400306 ◽

1996 ◽

Vol 4 (3) ◽

pp. 152-156 ◽

Cited By ~ 1

Author(s):

Zhu Ping ◽

Long Guo Cui ◽

Li Zhong Xue ◽

Feng Shu Sheng ◽

Meng Hua ◽

...

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Heart Valves ◽

Prosthetic Heart Valve ◽

Functional Class ◽

Prosthetic Heart Valves ◽

Class Iii ◽

Mechanical Prosthesis ◽

Actuarial Survival

Between July 1989 and July 1995, 89 CarboMedics prosthetic heart valves were implanted in 70 patients (38 males, 32 females) ranging in age from 13 to 54 years (mean 33 years). Forty-one of these patients underwent mitral valve replacement, 10 had aortic valve replacement, and 19 had double aortic and mitral valve replacement. Early mortality was 4.9%, 0%, and 15.8% respectively in these groups. Mean follow-up time was 3.4 years and was 95.4% complete (3 lost). There were 5 late deaths (7.7%); 1 in the mitral group, 1 in the aortic group, and 3 who had double valve replacements. Three of these late deaths were considered valve-related. The 5-year actuarial survival rates, hospital mortality excluded, were 97% for mitral, 88% for aortic, and 88% for double valve replacement. Preoperatively, 80% of the patients were in New York Heart Association functional class III or IV, whereas postoperatively, 99.5% of the patients were in class I or II. No structural failures were observed. There was 1 case of systemic embolism and 1 case of valve thrombosis, neither of these patients were taking anticoagulants. Hemorrhage was the most frequent complication; 1 of 4 events was fatal. A less intensive warfarin regimen and improvement in hepatic function may reduce hemorrhagic risk while maintaining thromboembolic protection. On the basis of this experience, the CarboMedics prosthetic heart valve appears to be an excellent mechanical prosthesis for cardiac valve replacement, in terms of hemodynamic performance and low thrombogenicity, in patients receiving anticoagulants.

Download Full-text

Transient Bilateral Blindness in a Patient after Cardiac Surgery

The Heart Surgery Forum ◽

10.1532/hsf98.20101123 ◽

2011 ◽

Vol 14 (3) ◽

pp. 198 ◽

Cited By ~ 1

Author(s):

Vakhtang Tchantchaleishvili ◽

Daniel J. Dibardino ◽

R. Morton Bolman

Keyword(s):

Cardiac Surgery ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Mitral Valve ◽

Coronary Artery Bypass ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Artery Bypass ◽

Bypass Grafting ◽

Mechanical Prosthesis

Our report describes a case of temporary bilateral blindness in a patient after undergoing mitral valve replacement with a mechanical prosthesis and coronary artery bypass grafting.

Download Full-text

Late atrioventricular groove disruption presenting 7 years after mitral valve replacement: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa091 ◽

2020 ◽

Vol 4 (3) ◽

pp. 1-5

Author(s):

Ciro Mancilha Murad ◽

Letícia Braga Ferreira ◽

Rochelle Coppo Militão Rausch ◽

Cláudio Léo Gelape

Keyword(s):

Heart Failure ◽

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Scar Tissue ◽

Mitral Valve Surgery ◽

Left Ventricular ◽

Valve Surgery ◽

Mechanical Prosthesis ◽

Atrioventricular Groove

Abstract Background Left ventricular rupture is the most feared complication in mitral valve surgery. Despite its low incidence, mortality rates can reach up to 75%. It usually presents on the operating room with a dissecting haematoma followed by massive bleeding after discontinuing cardiopulmomary bypass. However, cardiac rupture may be contained by adherent pericardium or scar tissue leading to chronic formation of a pseudoaneurysm (PSA). Case summary A 44-year-old man came to our institution with acute heart failure triggered by community-acquired pneumonia. He underwent mitral valve replacement with a mechanical prosthesis 7 years before and reported suffering from chronic worsening dyspnoea for 18 months. He underwent chest computed tomography scan and cardiac magnetic resonance imaging (CMRI), which showed two extensive left ventricular (LV) multilobulated PSAs. An operative approach was chosen and a tear was found on the posterior atrioventricular groove (AVG), communicating left ventricle with the PSA, which was closed with bovine pericardium patch. After weaning from cardiopulmonary bypass, he presented a diffuse life-threatening bleeding. The surgeons packed his chest with compresses before closing the sternum and he was operatively revised after 48 h. Post-operative CMRI showed that one of the PSAs remained connected with the LV. Despite of all, 1 year after hospital discharge, he remains asymptomatic without signs of heart failure. Discussion This case illustrates PSAs' potential to grow for a long period before causing symptoms, the complexity and risks of chronic AVG disruption surgery and the importance of careful annular manipulation and debridement as preventive measures in mitral valve surgery.

Download Full-text