Analysis of Dysfunctioning Mechanical Prostheses Excised from the Mitral Valve Position

  • William C Roberts
    Corresponding author: William C. Roberts, MD, Baylor Scott & White Heart and Vascular Institute, 621 N. Hall Street, Suite H-030, Dallas, Texas 75226, (214) 820-7911 Office, (214) 820-7533 Fax
    Baylor Scott & White Heart and Vascular Institute

    Departments of Internal Medicine (Division of Cardiology)

    Pathology, Baylor University Medical Center, Baylor Scott & White Health, Dallas, Texas
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  • Yusuf M Salam
    Baylor Scott & White Heart and Vascular Institute
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      Described herein are findings in 16 patients who had their dysfunctioning mechanical prostheses in the mitral valve position replaced. The mechanical prostheses had been in place from 2 to 157 months (mean 80). All but 1 patient had the mechanical prosthesis excised because of prosthetic stenosis or regurgitation or both secondary to prosthetic thrombus (despite warfarin therapy) on cloth-ring “pannus” overlaying the orifice or parabasilar detachment (“leak”). The dysfunction was the result of non-infected causes in 13 patients and to infective causes in 3. Three patients (19%) died in the early post-operative period; the other 13 patients survived >1 year. The prostheses were excised in a variety of methods by the explanting surgeons. The best procedure to excise the mechanical prosthesis appears to be mainly operator dependent.
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      1. Roberts WC, Salam YM. Analysis of Mechanical Prostheses Excised from the Aortic Valve Position. Am J Cardiol 2022;176:118–124

        • Roberts WC
        • Salam YM
        • Roberts CS
        Morphologic Findings in Native Mitral Valves Replaced for Isolated Acute Infective Endocarditis.
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      2. Roberts WC, Salam YM. Aortic valve replacement for active infective endocarditis limited to the native aortic valve. Am J Cardiol 2022; 170:76–82

      3. Roberts WC, Salam YM. Examination of operatively-excised bioprostheses in the mitral valve position to determine the reason for dysfunction. Am J Cardiol 2022;172:98–106

      4. Roberts WC, Manzoori S, Hassan MH, Salam YM. Infective endocarditis involving a bioprosthesis in the aortic valve position with operative excision. Am J Cardiol 2022;174:114–119

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