title: Perivalvular leakage 25 years after initial mitral valve replacement with a Björk-Shiley prosthesis.
abstract: An 80-year-old woman had undergone initial mitral valve replacement using a Björk-Shiley mechanical valve owing to mitral stenosis 25 years earlier. Suddenly, she had anemia and an increased lactic dehydrogenase (LDH) level. Transesophageal echography (TEE) showed perivalvular leakage. In a redo operation, two side-by-side stitches of the valve on the posterior annulus were loosened without cutting and the sewing cuff at that site was floated over the annulus, leading to the perivalvular leakage. The valve was easily removed; and round, hard, degenerative calcified tissue composed of remnant mitral valve in the suture site during the initial operation was found just under the sewing cuff. After resection of this calcified round tissue, a 25-mm bioprosthesis was put in place. Her postoperative recovery was uneventful, and 47 days after surgery she was discharged without perivalvular leakage or anemia.
authors.affiliation: Department of Cardiovascular Surgery, Miki City Hospital, 58-1 Kasa, Miki 673-0402, Japan. m-hiroya@muse.ocn.ne.jp
authors.forename: Hiroya
authors.initials: H
authors.lastname: Minami
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Asada
authors.forename: Kunio
authors.initials: K
authors.lastname: Gan
mesh_terms: D000369:Aged, 80 and over; D000743:Anemia, Hemolytic / Q000209:etiology; D002114:Calcinosis / Q000209:etiology; D020878:Device Removal; D017548:Echocardiography, Transesophageal; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome
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