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

2021 ◽  
Vol 14 (7) ◽  
pp. e243527
Author(s):  
Adil H Al Kindi ◽  
Ahmed Fahmy Mandisha ◽  
Mohamed Hammam ◽  
AbdelMaged Salem
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Bioprosthetic Valve ◽  
Patch Repair ◽  
Redo Surgery ◽  
Replacement Surgery ◽  
Coronary Artery Injury ◽  
History Of ◽  
Pericardial Patch Repair

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.

scholarly journals Left Atrial Ball-Shaped Thrombus with Concomitant Biatrial Appendage Thrombi in a Patient with Prior Mitral Valve Replacement

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Kanako Akamatsu ◽  
Takahide Ito ◽  
Kazushi Sakane ◽  
Yumiko Kanzaki ◽  
Koichi Sohmiya ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial ◽  
Atrial Appendage ◽  
Right Atrial ◽  
Replacement Surgery ◽  
History Of ◽  
Floating Ball ◽  
Right Atrial Appendage

We reported a 67-year-old woman in whom large atrial thrombi were found by chance during discontinuation of therapeutic anticoagulation. The patient, with a history of mitral valve replacement surgery, had stopped anticoagulation for months because of intractable gastrointestinal bleeding, during which she was found to have 3 large thrombi in the atria on transesophageal echocardiography: left atrial free-floating ball-shaped thrombus, left atrial appendage thrombus, and right atrial appendage thrombus. One month following diagnosis, she still had the free-floating thrombus despite adequate anticoagulation. Free-floating ball-shaped thrombus is a rare finding observed on echocardiography in patients with mitral valve disease and an even rarer finding in case of appendage thrombi coexisting.

RELATIONSHIP OF PREOPERATIVE RIGHT VENTRICULAR FUNCTION AND OUTCOME AFTER MITRAL VALVE REPLACEMENT SURGERY – A PROSPECTIVE OBSERVATIONAL STUDY

2020 ◽  
pp. 43-46
Author(s):  
Debashis Karmokar ◽  
Pinaki Majumdar ◽  
Manjushree Ray ◽  
Asim Kumar Kundu
Keyword(s):  
Mitral Valve ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Right Ventricular Function ◽  
Low Cardiac Output Syndrome ◽  
Replacement Surgery ◽  
Grade 3 ◽  
Valve Replacement Surgery

Objective:Right ventricular dysfunction constitutes a major risk factor for patients suffering from degenerative mitral valve disease. The objective of this study was to assess right ventricular function by echocardiography and to detect role of right ventricular functions in prediction of outcome following mitral valve replacement operation in patients with rheumatic heart disease involving mitral valve. Methods:Transthoracic 3D echocardiography was done in 52 patients posted for mitral valve replacement surgery. Right ventricular function was analyzed by measuring fractional area change (FAC) of right ventricle, tethering distance and, tricuspid annular plane systolic excursion (TAPSE). Tricuspid regurgitation was graded 0 to 4. Based on echocardiographic ndings of right ventricle, patients were allocated in two groups; Group A (normal right ventricular function) and Group B (poor right ventricular function). After surgery, incidence of complications such as; low cardiac output syndrome, refractory arrhythmia and, sepsis were compared in two group. Results: Incidence of postoperative complication such as low cardiac output syndrome and sepsis was signicantly more in patients with poor right ventricular function. Right ventricular variables, FAC <35%, TAPSE <17 mm and tethering distance > 8 mm are independent predictors of postoperative complications. Tricuspid valve was repaired in patients with grade 3 and 4 regurgitation. Therefore cardiopulmonary bypass time was signicantly more in patients with grade 3 and 4 TR (84.42±69.77 min) (p<0.01). Duration of intensive care support was also signicantly more in patients with poor right ventricular function (p<0.001) Conclusion: To predict possible complications and outcome following mitral valve replacement surgery, right ventricular functions should be thoroughly assessed by 3D echocardiography

scholarly journals A Giant Left Atrium due to Rheumatic Mitral Regurgitation, Outcome after Left Atrial Reduction Surgey with Mitral Valve Replacement

2018 ◽  
Vol 14 (1) ◽  
pp. 42-44
Author(s):  
Istiaq Ahmed ◽  
Sorower Hossain ◽  
Ankan Kumar Paul
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Left Atrium ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial ◽  
Quick Recovery ◽  
Replacement Surgery ◽  
Atrial Size ◽  
Giant Left Atrium

A trans-thoracic echocardiography and chest radiograph of a 26 year old lady diagnosed as rheumatic mitral regurgitation with atrial fibrillation revealed a giant left atrium of 10.9 cm size with symptoms of dyspnoea and palpitation. The patient was treated with left atrial size reduction along with mitral valve replacement surgery and showed an excellent and quick recovery with total disappearance of symptoms and restoration of sinus rhythm only within few days.University Heart Journal Vol. 14, No. 1, Jan 2018; 42-44

Giant Left Ventricular Pseudoaneurysm as a Complication After Mitral Valve Replacement Surgery

2014 ◽  
Vol 98 (4) ◽  
pp. 1480 ◽  
Author(s):  
Stefan Baumann ◽  
Matthias Renker ◽  
James V. Spearman ◽  
Richard R. Bayer ◽  
U. Joseph Schoepf ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Ventricular ◽  
Left Ventricular Pseudoaneurysm ◽  
Replacement Surgery ◽  
Valve Replacement Surgery

scholarly journals Role of per-operative milrinone on pulmonary hypertension having mitral valve replacement.

2021 ◽  
Vol 28 (01) ◽  
pp. 120-124
Author(s):  
Shahbaz Ahmad Khilji ◽  
Shuja Tahir ◽  
Shahid Abbas
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Nyha Class ◽  
Control Group ◽  
Study Group ◽  
Replacement Surgery ◽  
Valve Replacement Surgery

Objective: To determine the role of perioperative milrinone on pulmonary hypertension in patients with mitral valve disease undergoing mitral valve replacement surgery. Study Design: Randomized Control Trial. Setting: Department of Cardiac Surgery, Faisalabad Institute of Cardiology, Faisalabad. Period: June 2019 to June 2020. Material & Methods: A total of 80 patients with mitral valve disease who underwent mitral valve replacement were included. The patients were divided into a control group of 40, who were not administered milrinone, and a study group of 40 who received milrinone perioperatively. TVPG, LVEF and NYHA class were recorded preoperatively and postoperatively and were compared. Results: In the study group, postoperative LVEFs and NYHA class were not statistically significant in both groups while postoperative TVPG was significantly lower in study group as compare to control group and is statistically significant (P<0.001). Conclusion: Our study concludes that milrinone can be used as an effective therapy to reduce pulmonary pressure in patients with pulmonary hypertension undergoing mitral valve replacement surgery.

scholarly journals Lesion of Aggregated Monocytes and Mesothelial Cells: Mesothelial/Monocytic Incidental Cardiac Lesion

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Hilal Erinanç ◽  
Murat Günday ◽  
Tonguç Saba ◽  
Mehmet Özülkü ◽  
Atilla Sezgin
Keyword(s):  
Mitral Valve ◽  
Left Atrium ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Histopathological Examination ◽  
Mesothelial Cells ◽  
Mitral Valve Stenosis ◽  
Pathology Laboratory ◽  
Cardiac Lesion ◽  
Replacement Surgery

A 58-year-old woman with a history of childhood acute rheumatic fever and resultant mitral valve stenosis was admitted to our cardiovascular surgery clinic complaining of tachycardia, dyspnea, and chest pain. After clinical and radiological findings were evaluated, mitral valve replacement, tricuspid De Vega annuloplasty and plication, and resection of giant left atrium were performed. Atrial thrombus was removed from the top of the left atrial wall. Operation material considered as thrombus was sent to a pathology laboratory for histopathological examination. It was diagnosed with mesothelial/monocytic incidental cardiac lesion (cardiac MICE). Microscopic sections revealed that morphological features of the lesion were different from thrombus. The lesion was composed of a cluster of histiocytoid cells with abundant cytoplasm and oval shaped nuclei and epithelial-like cells resembling mesothelial cells within a fibrin network. Epithelial-like cells formed a papillary configuration in the focal areas. Mitotic figures were absent. Here we present a case which was incidentally found in a patient who underwent mitral valve replacement surgery, as a thrombotic lesion on the left atrium wall.

scholarly journals Effects of Controling of Post Operative Hypergycemia (Stress Induced Hyperglycemia) in Adult Non-Diabetic Patients Undergoing Mitral Valve Replacement Surgery Under Cardiopulmonary Bypass

2019 ◽  
Vol 34 (1) ◽  
pp. 44-51
Author(s):  
Md Armane Wadud ◽  
Syed Tanvir Ahmed ◽  
Shahnoor Aziz ◽  
Ibrahim Khalilullah ◽  
CM Shaheen Kabir
Keyword(s):  
Blood Glucose ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Postoperative Morbidity ◽  
Replacement Surgery ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Group B ◽  
Valve Replacement Surgery

Objectives: The objective of this study was to see whether there is an association between high blood glucose levels after operation under CPB and post operative morbidity and mortality. Methodology: This cohort study was carried out in the Department of Cardiac Surgery at National Institute of Cardiovascular DiseaseS (NICVD), Sher-e-Bangla Nagar, Dhaka from January, 2012 to December, 2013 for a period of twenty four (24) months. A total number of 110 patients who underwent MVR operation with CPB were enrolled in this study as per inclusion and exclusion criteria. Patients were divided into two groups according to their post operative blood glucose levels, recorded with in first 60 hrs after mitral valve replacement surgery under cardiopulmonay bypass. Patients having blood glucose level of less than 10.1 mmol/L (unexposed) and patients having blood lactate level of 10.1 mmol/L or more (exposed) were grouped. Post operative variables were observed and recorded during the hospital course of the patient. Result: A total number of 110 patients were enrolled in this study. Blood glucose levels lower than or equal to10 mmol/L after MVR were present in 55(50%) patients (Group A) Blood glucose levels higher than 10 mmol/L after MVR were present in 55(50%) patients. Postoperative morbidity was higher in this group ( Group B) than in the patients who had peak blood glucose levels of less than or equal to 10 mmol/L MVR (p 0.001). Postoperative ICU stay was prolonged in patients with elevated levels of blood glucose after MVR under CPB compared with of patients with lower blood glucose levels (p 0.001). Other common morbidities are neurological complication (p 0.04), renal dysfunction (p 0.01) , wound infection (p 0.04), post-operative hospital stay ( p0.004). also higher in group B patient, as well as mortality. Conclusions: Blood glucose concentration of 10.1 mmol/ L or higher after MVR under CPB is an important issues related to postoperative morbidity and mortality. Bangladesh Heart Journal 2019; 34(1) : 44-51

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