title: Prosthetic Valve Dysfunction 35 Years after Mitral Valve Replacement with a Starr-Edwards Caged-disc Valve.
abstract: A 49-year-old man was admitted to our hospital with a chief complaint of dyspnea. He had a history of mitral valve replacement (MVR) with a Starr-Edwards (SE) caged-disc valve at the age of 14. Echocardiography revealed elevated trans-valvular pressure gradient of the mitral prosthetic valve with neither disk motion abnormality nor abnormal structure. Catheterization confirmed an elevation of the mean diastolic gradient of the mitral valve to 12.3 mmHg. Re-MVR was performed, and abnormal tissue attached to the cage of the valve and proliferating beneath the valve was observed. Histologic examination revealed them as fibrinous tissue and mild pannus proliferation, respectively. This rare case report focuses on long-term follow-up and the complication of a SE caged-disc valve. A SE caged-disc valve may become stenotic, only detected with a trans-valvular pressure gradient without any disk motion abnormality or abnormal structure during a prolonged follow-up period.
authors.affiliation: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Yokokawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ohara
authors.forename: Seiji
authors.initials: S
authors.lastname: Takashio
authors.forename: Mari
authors.initials: M
authors.lastname: Sakamoto
authors.forename: Yuko
authors.initials: Y
authors.lastname: Wada
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakamura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takahama
authors.forename: Makoto
authors.initials: M
authors.lastname: Amaki
authors.forename: Takuya
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sugano
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kanzaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasuda
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Fujita
authors.forename: Junjiro
authors.initials: J
authors.lastname: Kobayashi
authors.forename: Yoko
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Taka-Aki
authors.initials: TA
authors.lastname: Matsuyama
authors.forename: Hatsue
authors.initials: H
authors.lastname: Ishibashi-Ueda
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Anzai
mesh_terms: D004417:Dyspnea / Q000209:etiology / Q000473:pathology*; D004452:Echocardiography; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology*; D008946:Mitral Valve Stenosis / Q000150:complications / Q000473:pathology*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016896:Treatment Outcome