Negin Yavari et al. Mina Ghorbanpour Landy Negar Omidi Mahmoud Shirzad Seyed Hossein Ahmadi Tafti
Introduction
Mitral valve replacement (MVR) in the context of calcification of the mitral valve annulus (<25 millimeters diameter) is challenging, with an increased risk of postoperative complications. Mitral annular calcification is more common in elderly patients due to secondary aging and tissue degeneration. It can also be found in younger patients with connective tissue disorders and inflammatory conditions including the Marfan’s syndrome, rheumatoid arthritis, and rheumatic fever. Calcification of the mitral annulus has been associated with arrhythmias, heart block, stenosis, valve insufficiency, bacterial endocarditis, and arterial embolization. Although the condition is not common, calcified mitral annulus may been found in patients requiring surgery for mitral valve dysfunction. However, replacement of a calcified valve is challenging especially because of the difficulty in placing the sutures through the calcified annulus, increasing the risk of leakage, poor positioning and dehiscence. , For this reason, some studies have suggested the implantation of an aortic mechanical valve (St. Jude Medical prosthesis) in mitral position due to its smaller surface area. Advantages of the St. Jude Medical valve prosthesis over other mechanical prostheses include a reduced sewing cuff size and a reduced frame diameter to allow a greater orifice area for a given annular size. There is limited number of studies on this kind of replacement surgeries, and here we report a case of successful placement of a St. Jude Medical aortic valve prosthesis in a calcified mitral annulus without postoperative complication.
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