Mitral Valve Replacement for Mitral Regurgitation with Annular Calcification after Esophageal Resection and Retrosternal Gastric Tube Reconstruction

(Department of Cardiovascular Surgery, Japan Red Cross Wakayama Medical Center, Wakayama, Japan, and Present address:Department of Cardiovascular Surgery, Kyoto University Hospital*, Kyoto, Japan)

Naoki Kanemitsu Masaki Aota Takeichiro Nakane
Takahide Takeda* Yutaka Konishi
A 79-year-old man developed congestive heart failure. He was given a diagnosis of severe mitral regurgitation with calcification of the posterior mitral annulus and secondary tricuspid regurgitation. He had a history of esophageal resection with retrosternal gastric tube reconstruction about 20 years previously. We replaced the mitral valve with a mechanical prosthesis and performed tricuspid ring annuloplasty through a right parasternal approach. We did not risk resecting the calcified annulus, but fixed the prosthesis and annulus with the equine pericardium in between as a cushion and collar, to prevent perivalvular leakage. The postoperative course was uneventful.
  Jpn. J. Cardiovasc. Surg. 39:216-219(2010)

Keywords:retrosternal gastric tube reconstruction, esophageal cancer, right parasternal approach, mitral valve replacement, mitral annular calcification