Key result
Redo surgery with a larger mechanical valve and interrupted sutures resolves severe mitral paravalvular leak.
Why the study?
Severe paravalvular leak soon after mitral valve replacement with a mechanical bileaflet valve is a critical complication requiring effective management strategies.
Case Report (n=1)
Redo surgery with a larger mechanical valve and interrupted sutures can successfully treat early severe paravalvular leak following mitral valve replacement.
May inform technique selection in refractory paravalvular leak; hypothesis-generating and should not yet change practice.
A middle-aged woman developed severe breathlessness soon after mitral valve replacement for rheumatic heart disease with severe mitral stenosis and moderate mitral regurgitation. Echocardiography (two-dimensional and transesophageal) revealed a severe paravalvular leak into the left atrium between the mechanical bileaflet mitral valve and the aortic annulus. The patient was stabilized with intravenous nitroglycerin and torsemide, and the heart rate was controlled with tablet metoprolol. The patient was successfully treated with a redo surgery using a larger mechanical mitral bileaflet valve (size 29 mm) and interrupted sutures. A 25-mm mechanical bileaflet valve was used during index surgery.
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Deepak Natarajan (2024) conducted a case report in Severe paravalvular leak following mitral valve replacement (n=1). Redo surgery using a larger mechanical mitral bileaflet valve (size 29 mm) and interrupted sutures was evaluated on Successful treatment of paravalvular leak. Redo surgery using a larger mechanical mitral bileaflet valve (29 mm) and interrupted sutures successfully treated a severe paravalvular leak following initial mitral valve replacement.
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