A Case of Redo-Aortic Valve Replacement for a Lillehei-Kaster Valve Implanted 42 Years Ago

Ryo Ikeda＊	Atomu Hino＊	Kozo Morita＊
Azumi Hamasaki＊	Hiroshi Niinami＊

（Department of Cardiovascular Surgery, School of Medicine, Tokyo Women’s Medical University＊, Tokyo, Japan）

We present a case of redo aortic valve replacement（AVR）in a 71-year-old man with a Lillehei-Kaster valve implanted 42 years prior. The patient initially underwent AVR and open mitral commissurotomy procedures for aortic regurgitation complicated with mitral stenosis in 1978 at the age of 29. Thereafter, he was followed at our outpatient clinic and treated without anticoagulant therapy for the initial two decades of the postoperative period. During the long-term follow-up, the mean pressure gradient remained between 40 and 60 mmHg and there were no adverse events noted before occurrence of heart failure triggered by tachycardia and pneumonia. Following improvement of heart failure, redo AVR was performed. There was no structural damage, thrombosis, or Lillehei-Kaster valve opening restrictions, though severe pannus growth on the left ventricle side was observed, which was thought to be the cause of the increased pressure gradient. This is the first known report of redo AVR after many years in a patient who underwent Lillehei-Kaster valve implantation. Furthermore, no other study has noted findings regarding pressure gradient change during the long-term follow-up period in such cases.

 

Jpn. J. Cardiovasc. Surg. 50:261-264（2021）

Keywords：tilted disk valve;Lillehei-Kaster valve;redo-aortic valve replacement;pannus formation;patient prosthesis mismatch（PPM）