Aortic and Mitral Valve Replacements in a Patient with Extensive Calcification of Intervalvular Fibrous Body

(Department of Cardiovascular Surgery, Kyoto University Hospital, Kyoto, Japan)

Masaki Funamoto Kenji Minakata Kazuhiro Yamazaki
Senri Miwa Akira Marui Hiroyuki Muranaka
Fumie Takai Motonori Kumagai Takahiro Nakahara
Ryuzo Sakata
Extensive calcification of the mitral annulus presents a formidable technical challenge to surgeons and increases the risk of serious complications such as intractable hemorrhage, atrioventricular disruption, and ventricular rupture during mitral valve surgery. We present a case of aortic and mitral valve replacements for a patient with extensive calcification of an intervalvular fibrous body. A 76-year-old woman was admitted with dyspnea on effort, leg edema and syncope. Transthoracic echocardiography showed severe aortic stenosis, and mitral stenosis with regurgitation, and extensive mitral annular calcification. Decalcification was performed with CUSA and we selected a trans-aortic-valve approach for decalcification of the intervalvular fibrous body. The calcification was left to a certain extent in order to preserve annular strength. Postoperative echocardiography showed no perivalvular leakage from either prostheses. The patient was transferred to a local hospital for further rehabilitation.
  Jpn. J. Cardiovasc. Surg. 41:308-311(2012)

Keywords:mitral annular calcification, intervalvular fibrous body, cavitron ultrasonic surgical aspirator, trans-aortic-valve approach, mitral valve replacement