title: [Reconstruction of the posterior mitral annulus using a crescent-shaped collar; a novel technique for mitral valve replacement in the severely calcified annulus; report of a case].
abstract: A 74-year-old female who had been on hemodialysis for 4 years developed congestive heart failure. Severe mitral valve stenosis and tricuspid regurgitation were thought to be causes of her heart failure. She underwent a replacement of severely calcified mitral valve and an annuloplasty of tricuspid valve. We excised both mitral leaflets, however, just a 21 mm sizer could pass through the annulus. Because posterior annular calcification was so severe we could not palace sutures. Therefore, we placed noneverted horizontal mattress sutures from the left ventricle to the atrium on the anterior annulus, and everted horizontal mattress sutures on the posterior left atrial wall. A crescent-shaped felt patch was sutured to the posterior left atrial wall for annular reconstruction. Then the prosthetic valve was fixed onto this felt patch, resulting a 25 mm ATS valve was seated successfully at a supraannular position. Although the patient died from a sepsis on postoperative day 14, the prosthetic valve functioned normally without any perivalvular leakage.
authors.affiliation: Department of Cardiovascular Surgery, Makiminato Central Hospital, Urazoe, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Tatsu
authors.forename: Moriichi
authors.initials: M
authors.lastname: Sugama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kamata
authors.forename: Toru
authors.initials: T
authors.lastname: Uezu
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Uechi
authors.forename: Kotaro
authors.initials: K
authors.lastname: Obunai
mesh_terms: D000368:Aged; D002114:Calcinosis; D006348:Cardiac Surgical Procedures / Q000379:methods; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve / Q000473:pathology* / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000601:surgery; D013536:Suture Techniques