Replacement of a Degenerated Mitral Bioprosthesis Using a Valve-on-Valve Technique / 日本心臓血管外科学会雑誌

ABSTRACT

A 79-year-old woman had received implantation of a pace maker for sick sinus syndrome at age 64 and tricuspid valve annuloplasty and Maze at age 68. Furthermore, she underwent tricuspid valve and mitral valve replacement with a bioprosthesis because of tricuspid valve and mitral valve regurgitation at age 73. She was referred to our institution for congestive heart failure in November 2005, because her bioprostheses at the mitral and tricuspid positions had shown significant regurgitation due to the degeneration of the prostheses, which required rereplacement. Because 1) surgical treatment of the heart had been performed twice in the past, 2) the general condition was not good owing to cirrhosis and hypothyroidism and 3) the durability of bioprostheses is short, we performed mitral valve re-replacement by using the “valve-on-valve” technique for reducing the invasion of surgical therapy. She had a satisfactory postoperative course. The “valve-on-valve” technique is a useful option for the re-replacement of bioprosthesis because it obviates the need for removing the sewing ring of the previous bioprosthesis.