A Perivalvular Leakage 25 Years after Mitral Valve Replacement by the Omnicarbon Valve Prosthesis

Abstract

A 79-year-old woman had undergone mitral valve replacement(Omnicarbon(OC)valve : 31 mm) due to rheumatic mitral stenosis with regurgitation and tricuspid annuloplasty at the age of 54. The patient developed anemia and congestive heart failure with pleural effusion and an elevated LDH level in 25 years late up without any valve-related cardiac event. Echocardiography revealed perivalvular leakage near the anterolateral commissure. The patient received re-mitral valve replacement(CEP valve : 25 mm)and a tricuspid valve ring annuloplasty(MC 3 Tricuspid ring : 28 mm). The annulus was covered with marked calcification and fibrosis with a partial deficit at the anterior part of antero-lateral commissure. Despite the thorough pathological examination, we could not clarify the etiology of sudden onset of hemolysis.The patient was discharged uneventfully on the 28th day after operation. In general, the OC valve can work without serious complications for a long time. We report a rare case of perivalvular leakage 25 years after mitral valve replacement with hemolysis and congestive heart failure. Jpn. J. Cardiovasc. Surg. 42 : 219-222(2013) Keywords：Omnicarbon valve, re-mitral valve replacement, perivalvular leakage, hemolytic anemia