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Rheumatic Mitral Valve Stenosis: A Surgical Case

  • Vitor Abaurre Amaral
  • Lissa Canedo Rocha
  • Gabriel Donato Amorim
  • Melchior Luiz Lima
Chapter

Abstract

On this chapter, we report a case of a 61-year-old woman presenting important mitral valve stenosis causing symptoms like fatigue and shortness of breath at rest (NYHA class IV). She reported a history of rheumatic fever in her childhood. The electrocardiogram (ECG) exposed a first-degree atrioventricular block, and auscultation revealed an opening snap associated with a diastolic murmur at the mitral point. Further investigation with echocardiography with Doppler brought to light a severe mitral stenosis (valve area = 0.88 cm2), leading to a severe increase of the left atrium. After studying the case with the heart team, mitral valve replacement was the procedure of choice. Her valve did not have a favorable morphology for percutaneous mitral balloon valvuloplasty (PMBV), and she was not a high-risk surgical candidate. Unfortunately, she was also not a candidate for minimally invasive cardiac surgery (MICS) due to a small anteroposterior chest diameter, which could possibly increase the procedure’s difficulty. The types of prosthetic valves were discussed with the patient and the choice was for a biological valve. The surgery was well conducted, and she was sent home after 1 week and 2 days. After describing precisely the surgery, we also discuss some matters regarding rheumatic fever and its importance (especially in Brazil), mitral valve stenosis, the Wilkins score, prosthetic valve types, mitral valve replacement, and its correlation with this case.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Vitor Abaurre Amaral
    • 1
  • Lissa Canedo Rocha
    • 1
  • Gabriel Donato Amorim
    • 1
  • Melchior Luiz Lima
    • 1
  1. 1.School of Sciences of Santa Casa de Misericórdia de Vitória (EMESCAM)VitóriaBrazil

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