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Commissural fusion as etiology of bioprosthetic mitral stenosis in a patient with rheumatic heart disease
Author(s) -
Vallabhaneni Srilakshmi,
Matka Marsel,
Olenchock Stephen,
Sarnoski Christopher,
Longo Santo,
Shirani Jamshid
Publication year - 2020
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14634
Subject(s) - medicine , stenosis , cardiology , mitral valve , etiology , mitral valve replacement , percutaneous , mitral valve stenosis , commissure , surgery , anatomy
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.