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Stepwise Annular Reconstruction for Redo Double-Valve Surgery in Severe Mitral Annular Calcification

Mohammad Sharaf1, Majed Tolah1, Darko Radakovic1

  • 1Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Medical School and University Medical Center OWL, University Bielefeld, Bad Oeynhausen, Germany.

JACC. Case Reports
|November 22, 2025
PubMed

Insights

This case study demonstrates a novel surgical approach for complex redo aortic and mitral valve surgery. Using a bovine pericardial patch for neo-annulus reconstruction enabled stable valve implantation in a patient with severe mitral annular calcification.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Valve Repair and Replacement
  • Surgical Innovation

Background:

  • Redo aortic and mitral valve surgery presents significant challenges, particularly with severe mitral annular calcification (MAC) and intervalvular fibrous body destruction.
  • The Commando procedure is often considered a last resort for these complex cases.
Abstract

Keywords:
aortomitral curtain reconstructionbovine pericardial patchintervalvular fibrous bodymitral annular calcificationmitral valve replacementredo cardiac surgery

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