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St. Jude prosthetic valve obstruction in the mitral position
Katsuhiko Matsuyama1, Tomohiro Nakayama, Hiroaki Hagiwara
1Department of Cardiovascular Surgery, Gifu Prefectural Tajimi Hospital, 5-161 Maehata, Tajimi, Gifu 507-8522, Japan. spgfs112@yahoo.co.jp
General Thoracic and Cardiovascular Surgery
|May 7, 2011
Summary
Prosthetic valve obstruction in a St. Jude Medical mitral valve was treated with re-do cardiac surgery. Early surgical intervention is crucial for patients with hemodynamic instability due to valve thrombosis.
Area of Science:
- Cardiology
- Cardiac Surgery
- Biomedical Engineering
Background:
- Mitral valve replacement surgery is a common procedure to treat severe mitral regurgitation or stenosis.
- Mechanical prosthetic valves, such as the St. Jude Medical valve, are frequently used.
- Prosthetic valve obstruction is a rare but serious complication.
Observation:
- A 66-year-old woman presented with congestive heart failure secondary to prosthetic valve obstruction.
- Transthoracic echocardiography and cine-fluoroscopy confirmed the obstruction.
- Surgical findings revealed circumferential pannus formation and fibrous overgrowth on the valve leaflet and atrial side.
Findings:
- The obstruction was caused by pannus ingrowth and fibrous tissue, not solely thrombus.
- Re-do cardiac surgery was successfully performed after a week of heparinization.
- Histopathological examination of the excised tissue is pending.
Implications:
- This case highlights the importance of differentiating valve thrombosis from pannus formation in prosthetic valve obstruction.
- Prompt diagnosis and surgical intervention are critical for managing hemodynamically unstable patients.
- Further research into the long-term management and prevention of prosthetic valve obstruction is warranted.
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