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Case reports

Intra-atrial implantation of a mitral valve prosthesis in a heavily calcified mitral annulus

^a Division of Cardiac Surgery, McGill University Health Center, Montreal, QC, Canada
^b Department of Anaesthesia, McGill University Health Center, Montreal, QC, Canada

Received 12 February 2009; received in revised form 25 May 2009; accepted 27 May 2009.

^_* Corresponding author. Address: Dr. Renzo Cecere, McGill University, Heart Failure & Thoracic Transplantation, Mechanical Cardiac Assist Program, McGill University Health Centre, 687 Pine Avenue West, Montreal, QC H3A1A1, Canada. Tel.: +1 514 934 1934x31463; fax: +1 514 934 8289. (Email: renzo.cecere{at}muhc.mcgill.ca).

Extensive annular calcification of the mitral valve can make anatomic implantation of a prosthesis extremely difficult and challenging. We herein describe a surgical technique of mitral valve replacement in a 78-year-old man with multiple medical co-morbidities suffering from severe mitral regurgitation with extensive circumferential calcification of the mitral annulus. The pertinent literature is reviewed and the technical steps and clinical presentation are discussed.

Key Words: Valve repair/replacement • Mitral regurgitation • Atrium • Calcification