Intraoperative Bioprosthetic Valve Dysfunction Causing Severe Mitral Regurgitation. 2017

Philip Y K Pang, and Susan Garwood, and Sabet W Hashim
Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut; Department of Cardiothoracic Surgery, National Heart Centre, Singapore. Electronic address: philip.pang.y.k@nhcs.com.sg.

Structural degeneration of bioprosthetic valves usually occurs gradually over time. Failure of a bioprosthetic valve immediately after implantation is extremely rare. Possible causes include obstruction of valve leaflets from preserved subvalvular tissue during chordal-sparing mitral valve replacement (MVR) or strut entrapment by suture loops. We report 2 cases of acute bioprosthetic mitral valve (MV) dysfunction involving newly implanted Perimount Theon (Edwards Lifesciences, Irvine, CA) bioprostheses, causing severe transvalvular mitral regurgitation (MR). Rapid diagnosis was achieved with the use of intraoperative transesophageal echocardiography (TEE). Operative assessment and examination of the explanted valves could not determine a definite cause of failure in either case.

UI MeSH Term Description Entries
D007431 Intraoperative Complications Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure. Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D008297 Male Males
D008944 Mitral Valve Insufficiency Backflow of blood from the LEFT VENTRICLE into the LEFT ATRIUM due to imperfect closure of the MITRAL VALVE. This can lead to mitral valve regurgitation. Mitral Incompetence,Mitral Regurgitation,Mitral Valve Incompetence,Mitral Insufficiency,Mitral Valve Regurgitation,Incompetence, Mitral,Incompetence, Mitral Valve,Insufficiency, Mitral,Insufficiency, Mitral Valve,Regurgitation, Mitral,Regurgitation, Mitral Valve,Valve Incompetence, Mitral,Valve Insufficiency, Mitral,Valve Regurgitation, Mitral
D011475 Prosthesis Failure Malfunction of implantation shunts, valves, etc., and prosthesis loosening, migration, and breaking. Prosthesis Loosening,Prosthesis Durability,Prosthesis Migration,Prosthesis Survival,Durabilities, Prosthesis,Durability, Prosthesis,Failure, Prosthesis,Failures, Prosthesis,Loosening, Prosthesis,Loosenings, Prosthesis,Migration, Prosthesis,Migrations, Prosthesis,Prosthesis Durabilities,Prosthesis Failures,Prosthesis Loosenings,Prosthesis Migrations,Prosthesis Survivals,Survival, Prosthesis,Survivals, Prosthesis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D001705 Bioprosthesis Prosthesis, usually heart valve, composed of biological material and whose durability depends upon the stability of the material after pretreatment, rather than regeneration by host cell ingrowth. Durability is achieved 1, mechanically by the interposition of a cloth, usually polytetrafluoroethylene, between the host and the graft, and 2, chemically by stabilization of the tissue by intermolecular linking, usually with glutaraldehyde, after removal of antigenic components, or the use of reconstituted and restructured biopolymers. Glutaraldehyde-Stabilized Grafts,Heterograft Bioprosthesis,Porcine Xenograft Bioprosthesis,Xenograft Bioprosthesis,Bioprostheses,Bioprostheses, Heterograft,Bioprostheses, Porcine Xenograft,Bioprostheses, Xenograft,Bioprosthesis, Heterograft,Bioprosthesis, Porcine Xenograft,Bioprosthesis, Xenograft,Glutaraldehyde Stabilized Grafts,Glutaraldehyde-Stabilized Graft,Graft, Glutaraldehyde-Stabilized,Grafts, Glutaraldehyde-Stabilized,Heterograft Bioprostheses,Porcine Xenograft Bioprostheses,Xenograft Bioprostheses,Xenograft Bioprostheses, Porcine,Xenograft Bioprosthesis, Porcine
D017548 Echocardiography, Transesophageal Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues using a transducer placed in the esophagus. Transesophageal Echocardiography
D019918 Heart Valve Prosthesis Implantation Surgical insertion of synthetic material to repair injured or diseased heart valves. Implantation, Heart Valve Prosthesis

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