title: Technical challenges and complications of double valve replacement in the presence of small aortic and mitral annuli.
abstract: A 57 year old female with rheumatic heart disease affecting both aortic and mitral valves underwent double valve replacement. The presence of small aortic and mitral annuli contributed to a series of intraoperative complications: left coronary ostium occlusion and type III atrioventricular groove disruption. The latter was repaired with a generous fresh autologous pericardial double layer patch and implant of a bileaflet mechanical prosthesis over the patch. Postoperatively, the patient developed prolonged respiratory insufficiency and pneumonia, transient myocardial dysfunction and acute renal failure. She was eventually discharged home without residual defects.
authors.affiliation: The Cleveland Clinic Foundation, Cleveland, Ohio, USA. atikf@ccf.org
authors.forename: Fernando Antibas
authors.initials: FA
authors.lastname: Atik
authors.forename: Gosta B
authors.initials: GB
authors.lastname: Pettersson
authors.forename: A Marc
authors.initials: AM
authors.lastname: Gillinov
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Lytle
mesh_terms: D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery; D001705:Bioprosthesis; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D007431:Intraoperative Complications; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000601:surgery; D011183:Postoperative Complications; D012214:Rheumatic Heart Disease / Q000150:complications*; D012720:Severity of Illness Index