title: Transapical Mitral Valve-in-Valve Replacement in Patient With Previous Complex Sternal Reconstruction.
abstract: We present a complex case of a transapical redo mitral valve-in-valve replacement. Repeat mitral valve replacement was indicated for severe symptomatic bioprosthetic stenosis. In addition to the patient's numerous comorbidities that included diabetes, hepatic cirrhosis, ischemic cardiomyopathy, and atrial flutter, he had undergone a previous open mitral valve replacement that was complicated by sternal dehiscence requiring extensive chest wall reconstruction. Transapical approach was performed through left minithoracotomy incision with balloon-expandable valve. Transapical valve-in-valve replacement of a stenotic mitral bioprosthesis is a viable solution in a patient with previous complex chest wall reconstruction and multiple comorbidities.
authors.affiliation: From the *Division of Cardiothoracic Surgery, Veterans Affairs Medical Center, Washington, DC USA; †Division of Cardiology, The George Washington University, Washington, DC USA; ‡Division of Cardiology, Veterans Affairs Medical Center, Washington, DC USA; and §Division of Cardiothoracic Surgery, The George Washington University, Washington, DC USA.
authors.forename: Conor F
authors.initials: CF
authors.lastname: Hynes
authors.forename: Omid
authors.initials: O
authors.lastname: Fatemi
authors.forename: Aditya C
authors.initials: AC
authors.lastname: Sharma
authors.forename: Christian D
authors.initials: CD
authors.lastname: Nagy
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Trachiotis
mesh_terms: D001705:Bioprosthesis / Q000009:adverse effects*; D020878:Device Removal; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D011475:Prosthesis Failure; D012086:Reoperation; D013249:Sternum / Q000601:surgery; D016896:Treatment Outcome