Commissural fusion as etiology of bioprosthetic mitral stenosis in a patient with rheumatic heart disease

Srilakshmi Vallabhaneni, Marsel Matka, Stephen Olenchock, Christopher Sarnoski, Santo Longo, Jamshid Shirani

Research output: Contribution to journalArticlepeer-review

Abstract

We report commissural fusion as a unique morphologic etiology of early bioprosthetic mitral valve failure in a woman with a history of rheumatic mitral stenosis. She had undergone mitral valve replacement with a 25-mm Edwards Magna Ease bovine pericardial bioprosthesis 3 years earlier and presented with progressive dyspnea. Transesophageal echocardiography revealed severe bioprosthetic stenosis due to commissural fusion. She underwent percutaneous valve-in-valve implantation with a 26-mm Edwards Sapien 3 prosthesis. Marked symptomatic improvement was noted postprocedurally. We speculate that commissural fusion may be a unique pathologic feature of failing bioprosthetic valves in patients with prior rheumatic mitral valve disease.

Original languageEnglish (US)
Pages (from-to)637-640
Number of pages4
JournalEchocardiography
Volume37
Issue number4
DOIs
StatePublished - Apr 1 2020
Externally publishedYes

Keywords

  • bioprosthesis
  • commissural fusion
  • early structural degeneration
  • rheumatic mitral stenosis
  • transcatheter valve replacement
  • valve-in-valve

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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