Mitral Valve Replacement for Bulky, Calcified Mitral Annulus: A Case Report.

Q4 Medicine
Journal of Chest Surgery Pub Date : 2024-09-05 Epub Date: 2024-06-05 DOI:10.5090/jcs.24.017
Yusuke Nakata, Kazuyuki Miyamoto
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引用次数: 0

Abstract

Calcification of the mitral valve annulus is common in patients on dialysis. The growing number of individuals receiving dialysis has been accompanied by an increase in cases necessitating surgical intervention for mitral valve annulus calcification. In this report, we present a severe case characterized by bulky calcification of the mitral annulus, which was managed with mechanical mitral valve replacement. A 61-year-old man on dialysis presented with chest pain upon exertion that had persisted for 3 months. Cardiac echocardiography revealed severe mitral stenosis and regurgitation, accompanied by cardiac dysfunction. During surgery, an ultrasonic aspiration system was employed to remove the calcification of the mitral valve annulus to the necessary extent. Subsequently, a mechanical mitral valve was sutured into the supra-annular position. To address the regurgitation, the area surrounding the valve was sewn to the wall of the left atrium. Postoperative assessments indicated an absence of perivalvular leak and demonstrated improved cardiac function. The patient was discharged on postoperative day 22. We describe a successful mitral mechanical valve replacement in a case of extensive circumferential mitral annular calcification. Even with severe calcification extending into the left ventricular myocardium, we were able to minimize the decalcification process. This approach enabled the performance of mitral mechanical valve replacement in a high-risk patient on dialysis, thus expanding the possibilities for cardiac surgery.

二尖瓣瓣环肥大、钙化的二尖瓣置换术:病例报告。
二尖瓣环钙化在透析患者中很常见。随着接受透析的人数不断增加,需要对二尖瓣环钙化进行手术干预的病例也随之增加。在本报告中,我们介绍了一个以二尖瓣瓣环大块钙化为特征的严重病例,该病例采用了二尖瓣机械置换术进行治疗。一名正在透析的 61 岁男性患者在劳累时出现胸痛,且已持续 3 个月。心脏超声心动图显示二尖瓣严重狭窄和反流,并伴有心功能不全。手术中,使用超声波抽吸系统对二尖瓣瓣环的钙化进行了必要的清除。随后,将机械二尖瓣缝合到瓣环上位置。为了解决反流问题,将瓣膜周围区域缝合到左心房壁上。术后评估显示瓣周没有渗漏,心功能也有所改善。患者于术后第 22 天出院。我们描述了一例二尖瓣环周广泛钙化的二尖瓣机械瓣膜置换术的成功案例。即使严重的钙化延伸至左心室心肌,我们仍能最大限度地减少脱钙过程。这种方法使二尖瓣机械瓣膜置换术得以在一名正在透析的高危患者身上实施,从而扩大了心脏手术的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Chest Surgery
Journal of Chest Surgery Medicine-Surgery
CiteScore
0.80
自引率
0.00%
发文量
76
审稿时长
7 weeks
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