Redo Mitral Valve Replacement using St. Jude Medical Mechanical Prostheses in a Patient with Degenerated Mitral Perimount Bioprosthesis: A Video Presentation

Current consensus guidelines of the American Heart Association and European Society of Cardiology, uniformly recommend either type of prosthetic mitral valve for patients aged 60 to 70 years, and mechanical prosthesis for patients less than 60 years.

A potential misdiagnosis in the COVID-19 pandemic era: a case report of superimposed thrombosis or tumor recurrence

Background The clinical manifestations of coronavirus disease 2019 (COVID-19) overlap with those of other disorders, especially cardiovascular disease. Case presentation We herein describe a 58-year-old woman who presented with syncopal episodes and dyspnea on exertion with a left atrial (LA) mass, scheduled for surgical removal and mitral valve replacement. Nearly 3 months later, the patient developed dyspnea, fever, and a sore throat, resulting in hospital admission with suspected COVID-19. During the diagnostic evaluation, a larger LA mass was detected. The mass seemed to be a COVID-19–induced organized thrombus with prosthetic mitral valve malfunction. Resection was, therefore, planned. An immunohistochemistry study revealed a liposarcoma. Conclusions The unusual early recurrence of liposarcomas and the misdiagnosis with COVID-19–induced thrombosis are the hallmark of the present case.

Demonstration of a Rocking Prosthetic Mitral Valve Using 3-Dimentional Echocardiography and Live Surgical Imaging

Prosthetic valve endocarditis is a complication of bacteremia which can cause damage to the prosthetic valve or the tissue to which it was sewn. Extensive tissue damage can result in a loss of anchoring and allow for abnormal valvular motion. Dehiscence can lead to excessive motion of the valve which is termed rocking. Through advances in imaging technology, live 3-dimentional (3-D) transesophageal echocardiography can allow for precise identification of the location of, and amount of dehiscence. We present a 37-year old male with a rocking prosthetic valve demonstrated on 3-D echocardiography and correlated to surgical manipulation.

Obstructive thrombosis of mitral prosthesis — diagnostic trap during a pandemic

Prosthetic obstructive thrombosis, being a major emergency, requires the identification of symptoms of heart failure, which are crucial elements in the early diagnosis and initiation of prompt therapeutic management. Adequate clinical, preclinical and instrumental assessment is the key tactic, used both to confirm the diagnosis and to assess the severity of the general condition and the prognosis of survival of the patient with obstructive thrombosis of the valve prosthesis. Prosthetic heart valve thrombosis is a rare but serious complication. Surgery is the first-line therapy in symptomatic obstructive mechanical valve thrombosis, thrombolytic therapy has been used as an alternative to surgical treatment. In this case report we described a 63-year-old woman who had undergone mitral valve replacement operation 11 months ago, presenting to the guard room in an extremely serious general condition, in polyvisceral and polysystemic dysfunction syndrome (MODS). A thrombus was detected on the prosthetic mitral valve with high transmitral gradient by transthoracic echocardiography. Tissue plasminogen activator treatment was administered successfully. The gradient was improved on prosthetic mitral valve and embolic complications or bleeding were not occurred.