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Mitral Regurgitation Exacerbation Due to Sutureless Aortic Valve Replacement
Timothy Lee1, Alexander J C Mittnacht2, Shinobu Itagaki1
1Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Sutureless aortic valve replacement (AVR) can cause new mitral regurgitation. Explantation and traditional valve implantation resolved this complication, suggesting a specific risk with sutureless devices.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Biomaterials Science
Background:
- Sutureless aortic valve replacement (AVR) offers excellent outcomes for severe aortic stenosis.
- Device implantation involves expansion within the native aortic root.
- Potential complications require thorough investigation.
Observation:
- A patient with severe aortic stenosis received a Perceval sutureless AVR.
- The prosthesis was competent, with no paravalvular leak or aortic regurgitation.
- Mitral regurgitation significantly worsened post-implantation.
Findings:
- Sutureless AVR implantation exacerbated pre-existing or induced new mitral regurgitation.
- Explantation of the sutureless valve and implantation of a traditional sutured valve resolved the mitral regurgitation.
- This suggests a potential complication specific to sutureless AVR devices.
Implications:
- Clinicians should be aware of the potential for sutureless AVR to exacerbate mitral regurgitation.
- Further research is needed to elucidate the exact mechanism of this complication.
- This finding may influence patient selection and surgical technique for AVR.
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