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You are here: Contents > 2018-19 > Volume 27 Number 6 (2018-19) > MITRAL VALVE DISEASE > Left Ventricular Outflow Tract Obstruction During Reoperative Mitral Valve Surgery: A Case Series

Left Ventricular Outflow Tract Obstruction During Reoperative Mitral Valve Surgery: A Case Series

Jared P. Beller1, William Z. Chancellor1, Mohammad Abuannadi2, Gorav Ailawadi1, Karen Singh3,4

1Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia, Charlottesville, VA, USA
2Division of Cardiovascular Medicine, Department of Medicine, University of Virginia, Charlottesville, VA, USA
3Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA
4Electronic Correspondence: kes2m@virginia.edu

Due to the intimate anatomic relationship between the mitral valve apparatus and left ventricular outflow tract (LVOT), care must be taken at the time of mitral valve intervention to avoid LVOT obstruction. Despite this being known as an early complication, the late development of outflow obstruction due to pannus formation/subaortic membrane is rarely described. Herein are presented three cases of this phenomenon in patients with previous bioprosthetic mitral valve replacement at three to six years after their initial operation. In this series, identification of the pathology occurred at different time points in the patients’ care, with

subsequent morbidity for delayed diagnosis. This series emphasizes the importance of vigilance, diagnosis and planning, particularly as transcatheter mitral valve intervention becomes more prevalent. When considering reintervention for patients with a bioprosthetic mitral valve, operators must be prepared for this underappreciated cause of LVOT obstruction.

Presented at The Heart Valve Society 4th Annual Scientific Meeting, 12th-14th April 2018, New York

The Journal of Heart Valve Disease 2018-19;27:324-327

Left Ventricular Outflow Tract Obstruction During Reoperative Mitral Valve Surgery: A Case Series

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