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Four Incidences of Recurrent Prosthetic Mitral Valve Detachment after DVR in a Single Patient Treated with Steroids
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（Department of Cardiovascular Surgery, Tokyo Women’s Medical University Medical Center East, Tokyo, Japan）
| Akihito Sasaki |
Kiyoharu Nakano |
Kojirou Kodera |
| Ryouta Asano |
Masahiro Ikeda |
Go Kataoka |
| Satoru Doumoto |
Wataru Tatsuishi |
Sayaka Kubota |
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A 47-year-old man underwent a double-valve replacement involving aortic valve replacement（AVR）and mitral valve replacement（MVR）and Re-Re-DVR 6 and 8 months, respectively, after an initial DVR because of suspected prosthetic valve endocarditis. Detachment of the prosthetic mitral valve occurred during the early postoperative period, for which the patient again underwent treatment 15 and 21 months after the initial surgery. The operative findings showed that the detachment was caused by a wide cleavage of the aortic-mitral continuity. There were bacteria detected on a blood culture, and his C-reactive protein（CRP）level did not reduce at any time. On the basis of these findings, we suspected nonrheumatic inflammatory disease and started steroid therapy. His CRP level became negative, and further prosthetic mitral valve detachment did not recur.
Jpn. J. Cardiovasc. Surg. 40:193-196（2011）
Keywords：prosthetic valve insufficiency, autoimmune disease, steroids, DVR
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