title: Unique nonstructural dysfunction of the omnicarbon valve: case report.
abstract: BACKGROUND
  Pannus formation may disturb the leaflet movement of the prosthetic valve.
  
  
  METHODS
  A 61-year-old woman presented with exertional dyspnea. She had undergone mitral valve replacement with a bioprosthetic valve 31 years ago, which was replaced with a tilting disc valve 22 years ago. The present laboratory findings revealed hemolytic anemia. Echocardiography showed an increased mean pressure gradient through the mitral valve and moderate to severe regurgitation around the minor orifice of the tilting disc valve. She therefore underwent a third operation. Pannus formation was found on the prosthetic valve ring, but it did not obliterate the prosthetic valve orifice. After removing the valve, the posterior wall of the left ventricle was seen to be associated with thickened endocardium. A bileaflet valve was implanted. Postoperative echocardiography showed that the implanted valve functioned well.
  
  
  CONCLUSIONS
  Nonstructural dysfunction of the mechanical heart valve might occur long after operation. These changes are particularly observed with a tilting disc valve.
authors.affiliation: Division of Cardiovascular Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotuske, Tochigi, 329-0498, Japan.
authors.forename: Soki
authors.initials: S
authors.lastname: Kurumisawa
authors.affiliation: Division of Cardiovascular Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotuske, Tochigi, 329-0498, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kaminishi
authors.affiliation: Division of Cardiovascular Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotuske, Tochigi, 329-0498, Japan.
authors.forename: Arata
authors.initials: A
authors.lastname: Muraoka
authors.affiliation: Division of Cardiovascular Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotuske, Tochigi, 329-0498, Japan. tcvmisa@jichi.ac.jp.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Misawa
mesh_terms: D004417:Dyspnea / Q000209:etiology; D005260:Female; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011475:Prosthesis Failure; D013997:Time Factors; D014463:Ultrasonography
keywords: Mitral valve replacement; Omnicarbon valve; Pannus formation