Cardiovascular Pharmacology: Open Access

A novel mechanical mitral valve replacement using Sapien XT

15^th International Conference on Pediatrics and Pediatric Cardiology

February 19-20, 2018 | Paris, France

Megan Koehle

Ludwig Maximilian University, Germany

Scientific Tracks Abstracts: Cardiovasc Pharm Open Access

Abstract:

We report the case of a 66 year old female who presented to our institution fourteen years after receiving a St. Jude Mechanical Mitral Valve Replacement. She presented in refractory NYHA class IV congestive heart failure with comorbidities of acute renal failure, liver failure, and mental status changes. She was found to have immobility of one of the mitral valve disks with resultant severe mitral stenosis with a mean pressure gradient of 12 mmHg. Evaluation and Management: The patient was found to have an STS predicted mortality of 39% with redo surgical MVR, and evaluation by the valve team led to a recommendation of a hybrid surgical and transcatheter procedure. The patient underwent femoral bypass and hypothermia with a sternotomy and left atrial approach. Subsequently, a 26 mm Edwards Sapien XT valve was deployed under direct and fluoroscopic visualization. The patient had an event free post-operativ e course, and one year following the proced ure has had an outstandi ng clinical response with NYHA class II congestive heart fai lure. Her echocardiogram reveals normal valve function with a MPG of 4 mmHg without mitral regurgitation. Conclusion: Transatrial hybrid TMVR within the ring of a St. Jude mechanical mitral valve appears to be a feasible procedure which may be used in the future to decrease morbidity and mortality associated with high-risk redo-MVR in patients with mechanical mitral valve prostheses.

Biography :

Megan Koehle is a Medical student at Ludwig Maximilian University in Munich, Germany. She is currently pursuing her Medical Doctorate with the research group SFB 914 at the same institution and is employed at the Munich Transplant Center.