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Prosthetic Valve Dysfunction 35 Years after Mitral Valve Replacement with a Starr-Edwards Caged-disc Valve. 2016
Tetsuro Yokokawa, and
Takahiro Ohara, and
Seiji Takashio, and
Mari Sakamoto, and
Yuko Wada, and
Kenji Nakamura, and
Hiroyuki Takahama, and
Makoto Amaki, and
Takuya Hasegawa, and
Yasuo Sugano, and
Hideaki Kanzaki, and
Satoshi Yasuda, and
Hisao Ogawa, and
Tomoyuki Fujita, and
Junjiro Kobayashi, and
Yoko Okamoto, and
Taka-Aki Matsuyama, and
Hatsue Ishibashi-Ueda, and
Toshihisa Anzai
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan.
A 49-year-old man was admitted to our hospital with a chief complaint of dyspnea. He had a history of mitral valve replacement (MVR) with a Starr-Edwards (SE) caged-disc valve at the age of 14. Echocardiography revealed elevated trans-valvular pressure gradient of the mitral prosthetic valve with neither disk motion abnormality nor abnormal structure. Catheterization confirmed an elevation of the mean diastolic gradient of the mitral valve to 12.3 mmHg. Re-MVR was performed, and abnormal tissue attached to the cage of the valve and proliferating beneath the valve was observed. Histologic examination revealed them as fibrinous tissue and mild pannus proliferation, respectively. This rare case report focuses on long-term follow-up and the complication of a SE caged-disc valve. A SE caged-disc valve may become stenotic, only detected with a trans-valvular pressure gradient without any disk motion abnormality or abnormal structure during a prolonged follow-up period.
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