title: Acute early failure of a bioprosthesis after mitral valve replacement with completely preserved annuloventricular continuity.
abstract: We report a case of acute early bioprosthetic failure after mitral valve replacement with completely preserved annuloventricular continuity. A 77-year-old man with left ventricular dysfunction underwent double valve replacement with Carpentier-Edwards pericardial bioprostheses. Routine postoperative echocardiography revealed 1.4 cm(2) of estimated mitral valve area, and computed tomography revealed a large thrombus in the left atrium. Transesophageal echocardiography showed a restricted opening of the bioprosthetic leaflets. After a month of strict anticoagulation therapy, cusp mobility improved, with a calculated mitral valve area of 3.5 cm(2); and the left atrial thrombus had almost disappeared 2 months after initiation of therapeutic anticoagulation. Surgeons should be watchful for bioprosthetic thrombosis in patients with left ventricular dysfunction who undergo mitral valve replacement with a preserved mitral subvalvular apparatus.
authors.affiliation: Department of Cardiovascular Surgery, Sakakibara Heart Institute of Okayama, 2-1-10 Marunouchi, Kita-ku, Okayama 700-0823, Japan. toshinoritotsugawa@mac.com
authors.forename: Toshinori
authors.initials: T
authors.lastname: Totsugawa
authors.forename: Hidenori
authors.initials: H
authors.lastname: Yoshitaka
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kuinose
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Tsushima
authors.forename: Atsuhisa
authors.initials: A
authors.lastname: Ishida
authors.forename: Genta
authors.initials: G
authors.lastname: Chikazawa
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001021:Aortic Valve / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis; D017548:Echocardiography, Transesophageal; D006349:Heart Valve Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D013927:Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology; D016277:Ventricular Function, Left
chemical_list: D000925:Anticoagulants