[Enlargement of the aortic and mitral double valve rings with double valve replacement using coupling valve method]

A 46-year-old woman was hospitalized with congestive heart failure. She had undergone a mitral valve replacement (23 mm) 17 years earlier and complicated a left ventricular rupture. Upon admission, she was diagnosed with aortic and mitral stenoinsufficiency with narrowed annuli on both valves, tricuspid insufficiency, and a left ventricular pseudoaneurysm. The operative procedure consisted of enlarging the aortic and mitral valve rings and replacing them by the coupling valve method. The orifice of the pseudoaneurysm was repaired with a patch closure applied from the endocardial side. A tricuspid annuloplasty was performed using the DeVega's method. Her postoperative course was uneventful. This is the first report of a successful operation to correct double narrowed annuli along with a ruptured left ventricule. The coupling valve procedure employed here should prove useful for similar cases requiring enlargement and replacement of the aortic and mitral valves simultaneously.