title: A valve replacement technique for heavily calcified mitral valve and annulus.
abstract: Severe mitral annular calcification is frequently encountered in patients with chronic renal failure requiring dialysis. The procedures are described for the implantation of mitral prostheses in two dialysis patients with mitral stenosis who exhibited heavily calcified mitral annuli. In both cases the calcifications extended around the entire mitral annulus as well as the valve leaflets, papillary muscle, atrial wall and ventricular myocardium, making it impossible to secure prosthetic valves to the mitral annuli. Before implantation, the calcification was partially debrided ultrasonically, and an 'atrioventricular channel' created. A mechanical valve with a polyester fabric collar was fixed on the atrial side of the calcified annulus using double sutures and gelatin-resorcin-formol glue. Perivalvular leakage, obstruction of valve opening or tortuous movements of prosthetic valve ring were not observed, and neither patient developed heart failure after surgery. This technique represents a potentially useful approach in the surgical treatment of patients with severely calcified mitral annuli.
authors.affiliation: Department of Cardiothoracic Surgery, Dokkyo University School of Medicine, Mibu, Tochigi, Japan. iidahomburg@hotmail.com
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iida
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Mochizuki
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsushita
authors.forename: Hideaki
authors.initials: H
authors.lastname: Mori
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamada
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyoshi
mesh_terms: D002114:Calcinosis / Q000473:pathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D006349:Heart Valve Diseases / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve