[Knack and pitfall in valve replacement].
We choose prosthetic or bioprosthetic valves according to AHA/ACC guidelines in valve replacement. It is important to remove only the calcification and avoid over-resection to preserve the valve annulus during aortic valve replacement. We leave posterior leaflet as well as basal chordae in mitral valve replacement in case of large mitral annulus. Sutures should be tied-down after those on both adjacent sides are pulled up and the sawing cuff and annulus are firmly attached. Intra-operative transesophageal echocardiography is useful for detecting a stack valve, perivalvular leakage and remnant air in the cardiac chambers. We performed 53 cases of valve replacement in 2009. One patient (1.9%) died because of ventricular arrhythmia during hospital stay. Re-operation was required in 2 cases (3.8%) of infective endocarditis due to prosthetic valve endocarditis. No other major complication was observed.
Takano
T
T
Department of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Amano
J
J
D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D019990:Perioperative Care / Q000379:methods