Mitral valve replacement for extensive calcification: half and half technique.
A 50-year-old woman who had been undergoing hemodialysis for 18 years underwent mitral valve replacement because of mitral valve stenosis. Her mitral valve leaflet and annulus were highly calcified, and it was impossible to remove the posterior leaflet from the ventricular wall. At the time of surgery, noneverted horizontal mattress sutures were placed from the left ventricle to the left atrium on the anterior half of the mitral annulus and everted horizontal mattress sutures on the left atrial wall close to the calcified posterior annulus. A 25-mm St. Jude valve was seated successfully at a supra-annular position. The St. Jude valve is suitable for this technique because its leaflets protrude less into the left ventricle.
Department of Cardiovascular Surgery, Kansai Rousai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan. ybito@med.osaka-cu.ac.jp
Yasuyuki
Y
Bito
Toshihiko
T
Shibata
Takashi
T
Yasuoka
Kazushige
K
Inoue
Takeshi
T
Ikuta
D002114:Calcinosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011474:Prosthesis Design; D013536:Suture Techniques; D016896:Treatment Outcome; D014463:Ultrasonography