Key result
Minimally invasive mitral annulus enlargement permits successful mechanical valve implantation for severe prosthesis-patient mismatch.
Case Report (n=1)
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Minimally invasive mitral annulus ring enlargement via right minithoracotomy is a feasible approach for treating severe prosthesis-patient mismatch in adults who received small mechanical valves in childhood.
Mechanical prosthesis is the first choice for valve replacement at the mitral position in children. Replacement of the original prosthesis because of prosthesis-patient mismatch (PPM) is almost inevitable when prostheses are implanted in small children. The impact of PPM on long-term mortality becomes significant when the effective orifice area (EOA) is severely reduced. In these cases prosthesis replacement can be technically difficult, and it often requires extended enlargement of the mitral valve annulus ring. We report a case of a woman who underwent a mitral valve replacement with a 19-mm St. Jude mechanical prosthetic valve at the age of 3 years. At the age of 33 years, the patient underwent a successful minimally invasive mitral annulus ring enlargement and implantation of a 23-mm St. Jude mechanical prosthetic valve via a right minithoracotomy.
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Attisani et al. (2014) conducted a case report in Severe Prosthesis-Patient Mismatch (n=1). Minimally invasive mitral annulus ring enlargement and mechanical prosthetic valve implantation was evaluated. Minimally invasive mitral annulus ring enlargement and 23-mm mechanical valve implantation was successfully performed in a 33-year-old woman with severe prosthesis-patient mismatch.
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