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European Journal of Cardio-Thoracic Surgery, Vol 12, 804-806, Copyright © 1997 by European Association for Cardio-thoracic Surgery

ARTICLES

Late, intermittent obstruction of a mitral prosthesis by chordal remnants

JP Greenwood, J Nolan and AF Mackintosh
Department of Cardiology, St James's University Hospital and Killingbeck Hospital, Leeds, UK.

A 59 year old male was admitted 10 weeks following insertion of a Medtronic Hall mitral prosthesis. He suffered recurrent episodes of electromechanical dissociation (EMD). Transthoracic echocardiography demonstrated that during the times of haemodynamic compromise, the mitral prosthesis was intermittently obstructed. Emergency surgical intervention revealed that chordae tendineae had prolapsed through the lesser orifice, obstructing the valve mechanism. The mitral remnants were excised, and as the valve functioned normally, it was not replaced. Postoperatively, the patient made an uneventful recovery. This case illustrates the Doppler echocardiographic features associated with extrinsic obstruction of a mitral prosthesis, and demonstrates that this unusual complication can be responsible for late valve dysfunction.


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W Keeble and S M Cobbe
Pressure damping, a "billowing" septum, and an eerie silence: perioperative, intermittent obstruction of a mitral valve prosthesis
Heart, September 1, 2000; 84 (3): e6 - e6.
[Abstract] [Full Text] [PDF]


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Copyright © 1997 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.