ABSTRACT
Aortic regurgitation in a bicuspid aortic valve is a complex entity that involves not only the semilunar valve but also the structure of the aortic root which is functionally and pathologically in a very close relationship to it. Considering repairing a bicuspid valve mandates a mindful involvement of all related structures concurrently. Here, we report an interesting case of both bicuspid aortic valve and mitral valve regurgitation in a patient with a history of infective endocarditis, that was successfully managed by double valve repair.
Subject(s)
Aortic Valve Insufficiency , Bicuspid Aortic Valve Disease , Mitral Valve Insufficiency , Aortic Valve/surgery , Aortic Valve Insufficiency/etiology , Aortic Valve Insufficiency/surgery , Humans , Mitral Valve/surgery , Mitral Valve Insufficiency/etiology , Mitral Valve Insufficiency/surgeryABSTRACT
INTRODUCTION: Mitral regurgitation (MR) is defined as an abnormal reversal of blood flow from the left ventricle to the left atrium (LA). It is caused by disruption in any part of the mitral valve apparatus. Surgical intervention remains the mainstay of management for severe cases. CASE SUMMARY: We are reporting a case of pneumonia with severe sepsis, that had a complicated hospital course. The patient developed multi-organ failure. Echocardiography on admission showed severe mitral regurgitation. He required early mechanical ventilation and then Veno-venous Extracorporeal Membrane Oxygenation (VV-ECMO) over 29 days. He might be the first case of Coronavirus Disease 2019 (COVID-19) in our hospital. Mitral valve replacement was done after stabilization of the patient and weaning from the ECMO. DISCUSSION: Our report demonstrates that the use of a long term VV-ECMO as a bridge for stabilization, facilitates management of the critically ill respiratory failure patient with severe MR and patient outcomes. Still the long-term results and the optimal timing of intervention need more research to define. CONCLUSION: Our report demonstrates that the use of a long term VV ECMO facilitates management of patients with respiratory failure associated with severe MR. Future studies focusing on stabilizing such patients, might help to define the optimal timing for intervention in these patients and the long-term outcome.