title: Enlargement of mitral valve ring in a young woman with severe prosthesis-patient mismatch.
abstract: Mechanical prosthesis is the first choice for valve replacement at the mitral position in children. Replacement of the original prosthesis because of prosthesis-patient mismatch (PPM) is almost inevitable when prostheses are implanted in small children. The impact of PPM on long-term mortality becomes significant when the effective orifice area (EOA) is severely reduced. In these cases prosthesis replacement can be technically difficult, and it often requires extended enlargement of the mitral valve annulus ring. We report a case of a woman who underwent a mitral valve replacement with a 19-mm St. Jude mechanical prosthetic valve at the age of 3 years. At the age of 33 years, the patient underwent a successful minimally invasive mitral annulus ring enlargement and implantation of a 23-mm St. Jude mechanical prosthetic valve via a right minithoracotomy.
authors.affiliation: Cardiac Surgery Division, University of Turin, San Giovanni Battista Hospital, Turin, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Attisani
authors.affiliation: Cardiac Surgery Division, University of Turin, San Giovanni Battista Hospital, Turin, Italy.
authors.forename: Augusto
authors.initials: A
authors.lastname: Pellegrini
authors.affiliation: Cardiac Surgery Division, University of Turin, San Giovanni Battista Hospital, Turin, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Sorrentino
authors.affiliation: Cardiac Surgery Division, University of Turin, San Giovanni Battista Hospital, Turin, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Rinaldi
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D058386:Mitral Valve Annuloplasty / Q000295:instrumentation* / Q000379:methods*; D008946:Mitral Valve Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D017755:Prosthesis Fitting / Q000009:adverse effects*; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome