ABSTRACT
We report a case of catastrophic hemodynamic compromise secondary to pannus ingrowth and severe mitral stenosis occurring years after repair of a nonrheumatic mitral valve. The initial repair included closure of a posterior leaflet cleft and implantation of an annuloplasty ring. We describe a hybrid treatment strategy for this severely compromised patient, which included initial placement of a right ventricular assist device followed by percutaneous balloon mitral valvuloplasty and, eventually, a definitive mitral valve reoperation. This case report reinforces the importance of routine clinical and echocardiographic follow-up for patients after mitral valve repair, and it includes the description of a novel therapeutic approach.
Subject(s)
Heart Valve Prosthesis , Mitral Valve Annuloplasty/adverse effects , Mitral Valve Insufficiency/surgery , Mitral Valve Stenosis/surgery , Mitral Valve/surgery , Postoperative Complications , Adult , Echocardiography , Female , Heart Valve Prosthesis Implantation , Humans , Mitral Valve Insufficiency/diagnosis , Mitral Valve Stenosis/diagnosis , Mitral Valve Stenosis/etiology , ReoperationSubject(s)
Fee-for-Service Plans/trends , Fees, Medical/trends , Health Care Costs/trends , Intensive Care Units/economics , Quality of Health Care/trends , Telemedicine/economics , Clinical Coding/trends , Cost Savings/economics , Humans , Medicaid/economics , Medicare/economics , Quality of Health Care/economics , United StatesABSTRACT
Prolonged open sternotomy is a well-known phenomenon in the pediatric and adult cardiac surgery literature. It is usually an adjuvant in the treatment of a severely compromised heart. We present a case of thoracic compartment syndrome that developed postoperatively from a noncardiac thoracic procedure. Management, diagnosis, and literature review are presented.
