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Re-do mitral valve replacement for a bioprosthetic valve with central transvalvular leakage in a patient with ischemic cardiomyopathy: a case report

  • Tatsuya Seki
  • Yasushige Shingu
  • Satoru Wakasa
  • Hiroki Katoh
  • Tomonori Ooka
  • Tsuyoshi Tachibana
  • Suguru Kubota
  • Yoshiro Matsui
Case Report Artificial Valve
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Abstract

Transvalvular leakage (TVL) of a prosthetic heart valve is not negligible regurgitant flow in patients with critically low contractile function. Although the opening function of prosthetic valves has been reported, its closing function is not well understood. A man in his 70 s had a history of mitral valve replacement (MVR) with a Magna Mitral® valve for ischemic mitral valve regurgitation. He presented with dyspnea 2 years postoperatively. Echocardiography showed moderate TVL. The pulmonary capillary wedge pressure and cardiac index were 37 mmHg and 1.65 L/min/m2, respectively. Because we considered his TVL relevant, we performed re-do MVR with a mechanical valve and papillary muscle approximation and suspension (“papillary muscle tugging approximation”). His cardiac function improved postoperatively; he was discharged with New York Heart Association class I. For MVR in patients with critically low contractile function, prosthetic valves, such as mechanical valves, with small TVL are recommended.

Keywords

Bioprosthetic valve Mechanical valve Transvalvular leakage 

Notes

Acknowledgements

We would like to thank Editage (http://www.editage.jp) for English language editing.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

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Copyright information

© The Japanese Society for Artificial Organs 2019

Authors and Affiliations

  • Tatsuya Seki
    • 1
  • Yasushige Shingu
    • 1
  • Satoru Wakasa
    • 1
  • Hiroki Katoh
    • 2
  • Tomonori Ooka
    • 1
  • Tsuyoshi Tachibana
    • 1
  • Suguru Kubota
    • 1
  • Yoshiro Matsui
    • 1
  1. 1.Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, Graduate School of MedicineHokkaido UniversitySapporoJapan
  2. 2.Emergency and Critical Care CenterHokkaido University HospitalSapporoJapan

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