title: A rare complication of mitral valve replacement. Intraoperative fracture of the right fibrous trigone following a superior approach to the left atrium. Case report.
abstract: A rare complication of mitral valve replacement is reported. Following a superior approach, through the roof of the left atrium the mitral valve was replaced with a Björk-Shiley prosthesis in a 52-year-old female, who had undergone previous closed commissurotomy. Fracture of the right fibrous trigone occurred at surgery, following the completion of mitral valve replacement. The lesion was successfully repaired on cardiopulmonary bypass under cardioplegic arrest, placing sutures, after an oblique aortotomy, from below the noncoronary aortic cusp. The postoperative course was uneventful, without occurrence of a-v block. We believe that a superior approach to the left atrium may be a valid alternative for mitral valve surgery in some selected cases.
authors.affiliation: Divisione di Cardiochirurgia, Policlinico di Careggi, Florence, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Nigro
authors.forename: G
authors.initials: G
authors.lastname: Montesi
authors.forename: F
authors.initials: F
authors.lastname: Alajmo
authors.forename: G
authors.initials: G
authors.lastname: Calamai
mesh_terms: D005260:Female; D006325:Heart Atria; D006335:Heart Injuries / Q000209:etiology*; D006350:Heart Valve Prosthesis / Q000009:adverse effects* / Q000379:methods; D006352:Heart Ventricles / Q000293:injuries; D006801:Humans; D007431:Intraoperative Complications; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000601:surgery*; D012086:Reoperation