[A case report on prosthetic valve dysfunction of the Carpentier-Edwards pericardial bioprosthesis in the tricuspid position associated with remarkable hypoproteinemia].
A 66-year-old woman underwent a second tricuspid valve replacement because of a malfunction of the Carpentier-Edwards pericardial bioprosthesis (CEP) in the tricuspid position 3.5 years after her first mitral and tricuspid valve replacement. The major symptom was lower leg edema and a serum albumin level ranging between 1.5 g/dl and 2.0 g/dl. The remarkable hypoproteinemia might have resulted from impaired albumin synthesis due to liver dysfunction, hemodilution, protein losing gastroenteropathy, and changes in albumin distribution due to edema. Although the explanted CEP showed neither dehiscence nor calcification of the leaflet, fibrous pannus mainly on the ventricular side restricted the mobility of the corresponding leaflet. Patients receiving a CEP in the tricuspid position should receive careful follow-up.
Hirai
M
M
Department of Thoracic and Cardiovascular Surgery, Meijo Hospital of Federation of National Public Service, Nagoya, Japan.
Maki
S
S
Yasuda
T
T
Kondo
M
M
D000368:Aged; D001705:Bioprosthesis; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D007019:Hypoproteinemia / Q000209:etiology*; D011475:Prosthesis Failure; D014261:Tricuspid Valve; D014262:Tricuspid Valve Insufficiency / Q000209:etiology