Transventricular Cardioscopic Release of a Trapped Prosthetic Mitral Valve Leaflet

Nicholas J.S. Chilvers, Zachariah M. Evans*, Sankar Balasubramanian, Denis O’Leary, Simon Ledingham, Stephen C. Clark

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Trapped prosthetic valve leaflets are a rare but challenging complication. A 68-year-old male patient had previously undergone redo aortic valve replacement. Postoperatively, he decompensated with severe mitral regurgitation, requiring extracorporeal membrane oxygenation and a salvage mitral valve replacement via right thoracotomy with very difficult access. This procedure was complicated by a trapped valve leaflet. He recovered well initially but presented 2 years later with worsening heart failure due to mitral stenosis and rising pulmonary artery pressures. Due to the high risk of sternotomy and right thoracotomy, a transventricular cardioscopic release of the trapped mitral valve leaflet was undertaken by left minithoracotomy. The procedure was successful, and the patient was discharged home on day 12. This novel minimally invasive approach, which does not require myocardial preservation, is ideal for high-risk patients with this rare complication and has not previously been described. We hope that by sharing our experience, others will consider this innovative approach.

Original languageEnglish
Pages (from-to)494-497
Number of pages4
JournalInnovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Volume18
Issue number5
Early online date23 Aug 2023
DOIs
Publication statusPublished - 1 Sept 2023

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