Rheumatic Mitral Valve Stenosis: A Surgical Case

Autor: Lissa Canedo Rocha, Melchior Luiz Lima, Gabriel Donato Amorim, Vitor Abaurre Amaral
Rok vydání: 2018
Předmět:
Zdroj: Cardiovascular Surgery ISBN: 9783319570839
DOI: 10.1007/978-3-319-57084-6_38
Popis: On this chapter, we report a case of a 61-year-old woman presenting important mitral valve stenosis causing symptoms like fatigue and shortness of breath at rest (NYHA class IV). She reported a history of rheumatic fever in her childhood. The electrocardiogram (ECG) exposed a first-degree atrioventricular block, and auscultation revealed an opening snap associated with a diastolic murmur at the mitral point. Further investigation with echocardiography with Doppler brought to light a severe mitral stenosis (valve area = 0.88 cm2), leading to a severe increase of the left atrium. After studying the case with the heart team, mitral valve replacement was the procedure of choice. Her valve did not have a favorable morphology for percutaneous mitral balloon valvuloplasty (PMBV), and she was not a high-risk surgical candidate. Unfortunately, she was also not a candidate for minimally invasive cardiac surgery (MICS) due to a small anteroposterior chest diameter, which could possibly increase the procedure’s difficulty. The types of prosthetic valves were discussed with the patient and the choice was for a biological valve. The surgery was well conducted, and she was sent home after 1 week and 2 days. After describing precisely the surgery, we also discuss some matters regarding rheumatic fever and its importance (especially in Brazil), mitral valve stenosis, the Wilkins score, prosthetic valve types, mitral valve replacement, and its correlation with this case.
Databáze: OpenAIRE