Preanesthetic Cardiopulmonary Bypass for Mechanical Mitral Valve Dysfunction

Although the overall performance of prosthetic heart valves is excellent, prosthesis-related problems occur within 10 years of surgery in 30% to 35% of patients with a mechanical prosthesis [1]. Mechanical valve dysfunction is one of the most dreadful complications following heart valve replacement. It generally causes acute pulmonary edema and acute cardiac failure and necessitates urgent intervention [2]. Induction of anesthesia may cause cardiac arrest due to decreased pulmonary and cardiac reserves. We described our method of cannulation to overcome the risks of both anesthesia induction and Trendelenburg position for patients with mechanical valve dysfunction. This article presents four urgent surgical cases of mechanical valve dysfunction with acute pulmonary edema and cardiac insufficiency.