Abscess resection and prosthesis reimplantation is the only effective treatment for mitral prosthesis endocarditis with extensive annular abscess, but it has high morbidity and mortality when associated with severe mitral annular calcification in the atrial and ventricular walls. We describe a technique that allows repair of the abscess cavity, reconstruction of the annulus, and implantation of a new mitral prosthesis when there is severe adjacent myocardial calcification, so decreasing the reoperation risk.
MusciMHüblerMAmiriASteinJKoskySMeyerR. Surgical treatment for active infective prosthetic valve endocarditis: 22-year single-centre experience. Eur J Cardiothorac Surg2010; 38: 528–538.
2.
AlexiouCLangleySMStaffordHHawMPLiveseySAMonroJL. Surgical treatment of infective mitral valve endocarditis: predictors of early and late outcome. J Heart Valve Dis2000; 9: 317–334.
3.
CarpentierAFPellerinMFuzellierJFRellandJY. Extensive calcification of the mitral valve anulus: pathology and surgical management. J Thorac Cardiovasc Surg1996; 111: 718–730.
4.
RuvoloGSpezialeGVociPMarinoB. “Patch-glue” annular reconstruction for mitral valve replacement in severely calcified mitral annulus. Ann Thorac Surg1997; 63: 570–571.
5.
David TE, Kuo J, Armstrong S. Aortic and mitral valve replacement with reconstruction of the intervalvular fibrous body. J Thorac Cardiovasc Surg 1997; 114: 766–771.
6.
De OliveiraNCDavidTEArmstrongSIvanovJ. Aortic and mitral valve replacement with reconstruction of the intervalvular fibrous body: an analysis of clinical outcomes. J Thorac Cardiovasc Surg2005; 129: 286–290.
7.
de KerchoveLVanoverscheldeJLPonceletAGlineurDRubayJZechF. Reconstructive surgery in active mitral valve endocarditis: feasibility, safety and durability. Eur J Cardiothorac Surg2007; 31: 592–599.
8.
NatafPPavieAJaultFBorsVCabrolCGandjbakhchI. Intraatrial insertion of a mitral prosthesis in a destroyed or calcified mitral annulus. Ann Thorac Surg1994; 58: 163–167.
9.
MandegarMHSaidiBRoshanaliF. Modification of the intra-atrial valve prosthesis implantation in cases of heavy mitral annulus calcification. Eu J Cardiothorac Surg2010; 38: 236–236.
10.
KurazumiHMikamoASuzukiRHamanoK. Mitral-valve replacement for a severely calcified mitral annulus: a simple and novel technique. Eur J Cardiothorac Surg2011; 39: 407–409.
11.
NomuraAFukudaIDaitokuKFukuiK. Enucleation of calcium core and in-situ valve replacement for massive posterior mitral annual calcification. Interact Cardiovasc Thorac Surg2011; 12: 652–654.
