A 32-year-old female underwent mitral valve replacement with total chordal preservation (Miki's technique) using 26mm (1M) Starr-Edward prosthesis (SEP) in 1988. The patient was in NYHA class-I until 2001. She progressed to NYHA class-III with paroxysmal nocturnal dyspnoea. Transthoracic echocardiogram showed increased prosthetic valve gradient, and cardiac catheterization confirmed the findings. Intraoperatively, the poppet movement in the cage was found to be restricted due to the preserved subvalvular apparatus entrapping the poppet inside the prosthetic valve cage.
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References
1.
LilleheiCWLevyMJBonnabeauRCJrMitral valve replacement with preservation of papillary muscles and chordae tendineae. J Thorac Cardiovasc Surg1964;57:532–43.
2.
MikiSKusuharaKUedaYKomedaMOhkitaY. Mitral valve replacement with preservation of chordae tendineae and papillary muscles. Ann Thorac Surg1988;45:28–34.
3.
DavidTE. Mitral valve replacement with preservation of chordae tendineae: Rationale and technical considerations. Ann Thorac Surg1986;41:680–2.
4.
DavidTEBurnsRJBacchusCMDruckMN. Mitral valve replacement for mitral regurgitation with and without preservation of chordae tendineae. J Thorac Cardiovasc Surg1984;88:718–25.
5.
WilliamsDBPluthJROrszulakTA. Extrinsic obstruction of the Bjork-Shiley valve in the mitral position. Ann Thorac Surg1981;32:58–62.
6.
TritesPNKiserJCJohnsonCTycastFJGobelFC. Occlusion of Medtronic Hall mitral valve prosthesis by ruptured papillary muscle and chordae tendineae. J Thorac Cardiovasc Surg1984;88:301–2.
7.
PrabhakarGKumarNHatleLal-HaleesZ. Accelerated failure of bioprosthesis by entrapment in chordal-sparing mitral valve replacement. J Thorac Cardiovasc Surg1994;108:185–7.
8.
KarlsonKJAshrafMMBergerRL. Rupture of left ventricle following mitral valve replacement. Ann Thorac Surg1988;46:590–7.
