Reconstructive surgery of an extremely calcified mitral valve in a Barlow disease patient: A case report
Rekonstruktivna hirurgija ekstremno kalcifikovane mitralne valvule kod bolesnika sa Barlovljevom bolesti
Apstrakt
Introduction. Mitral valve calcifications are frequent finding in Barlow disease. This is making mitral repair surgery even more demanding in already complex valve pathology. Case report. A fifty-five-year-old Barlow disease patient underwent a mitral repair surgery due to posterior leaflet prolapse at P2 level and extensive posterior leaflet and annular calcifications as well. The prolapsed scallop was resected, while P1 and P3 scallops were detached from the annulus. After complete posterior annulus decalcification, so formed the large atrio-ventricular defect was reconstructed with the autologous pericardial patch and double suture line technique. The P1 and P3 segments were reattached there by the sliding technique and sutured with no strain. Annuloplasty was performed with a saddle rigid ring No 36. The patient was discharged nine days after the surgery with just a trace of mitral regurgitation. Conclusion. Annular decalcification and reconstruction in the patients with calcified ...Barlow mitral disease is necessary for safe and durable mitral valve surgical repair.
Uvod. Kalcifikacije mitralne valvule su čest nalaz kod bolesnika sa Barlovljevom bolesti što čini rekonstruktivnu hirurgiju zalistka kod ovih bolesnika znatno složenijom. Prikaz bolesnika. Bolesniku starom 55 godina je urađena rekonstrukcija mitralnog zalistka zbog prolapsa posteriornog listića i značajnih kalcifikacija na P2 segmentu i posteriornom anulusu. Nakon resekcije P2 segmenta i odvajanja P1 i P3 segmenta od anulusa, urađena je kompletna resekcija velikog kalcifikata sa skoro polovine obima posteriornog anulusa. Nastali atrioventrikularnog defekt rekonstruisan je autolognim perikardom elipsoidnog oblika sašivenim u dva sloja. P1 i P3 segment su potom reinplantirani na rekonstruisani anulus i međusobno spojeni. Rekonstruktivna procedura je kompletirana anuloplastikom pomoću sedlastog rigidnog prstena veličine 36. Bolesnik je otpušten devetog postoperativnog dana sa neznatnom mitralnom regurgitacijom. Zaključak. Dekalcifikacija posteriornog anulusa uz preciznu rekonstrukciju nas...talog atrioventikularnog defekta je neophodna procedura za bezbednu i funkcionalno trajnu rekonstrukciju mitralnog zalistka.
Ključne reči:
barlow syndrome / mitral valve stenosis / mitral valve annuloplasty / reconstructive surgical procedures / sindrom barlow / zalistak, mitralni, stenoza / zalistak, mitralni, anuloplastika / hirurgija, rekonstruktivne procedureIzvor:
Vojnosanitetski pregled, 2019, 76, 5, 552-554Izdavač:
- Vojnomedicinska akademija - Institut za naučne informacije, Beograd
DOI: 10.2298/VSP170312117S
ISSN: 0042-8450
WoS: 000504433600014
Scopus: 2-s2.0-85069683650
Institucija/grupa
PharmacyTY - JOUR AU - Stojanović, Ivan AU - Kaitović, Marko AU - Novaković, Aleksandra AU - Vuković, Petar PY - 2019 UR - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3273 AB - Introduction. Mitral valve calcifications are frequent finding in Barlow disease. This is making mitral repair surgery even more demanding in already complex valve pathology. Case report. A fifty-five-year-old Barlow disease patient underwent a mitral repair surgery due to posterior leaflet prolapse at P2 level and extensive posterior leaflet and annular calcifications as well. The prolapsed scallop was resected, while P1 and P3 scallops were detached from the annulus. After complete posterior annulus decalcification, so formed the large atrio-ventricular defect was reconstructed with the autologous pericardial patch and double suture line technique. The P1 and P3 segments were reattached there by the sliding technique and sutured with no strain. Annuloplasty was performed with a saddle rigid ring No 36. The patient was discharged nine days after the surgery with just a trace of mitral regurgitation. Conclusion. Annular decalcification and reconstruction in the patients with calcified Barlow mitral disease is necessary for safe and durable mitral valve surgical repair. AB - Uvod. Kalcifikacije mitralne valvule su čest nalaz kod bolesnika sa Barlovljevom bolesti što čini rekonstruktivnu hirurgiju zalistka kod ovih bolesnika znatno složenijom. Prikaz bolesnika. Bolesniku starom 55 godina je urađena rekonstrukcija mitralnog zalistka zbog prolapsa posteriornog listića i značajnih kalcifikacija na P2 segmentu i posteriornom anulusu. Nakon resekcije P2 segmenta i odvajanja P1 i P3 segmenta od anulusa, urađena je kompletna resekcija velikog kalcifikata sa skoro polovine obima posteriornog anulusa. Nastali atrioventrikularnog defekt rekonstruisan je autolognim perikardom elipsoidnog oblika sašivenim u dva sloja. P1 i P3 segment su potom reinplantirani na rekonstruisani anulus i međusobno spojeni. Rekonstruktivna procedura je kompletirana anuloplastikom pomoću sedlastog rigidnog prstena veličine 36. Bolesnik je otpušten devetog postoperativnog dana sa neznatnom mitralnom regurgitacijom. Zaključak. Dekalcifikacija posteriornog anulusa uz preciznu rekonstrukciju nastalog atrioventikularnog defekta je neophodna procedura za bezbednu i funkcionalno trajnu rekonstrukciju mitralnog zalistka. PB - Vojnomedicinska akademija - Institut za naučne informacije, Beograd T2 - Vojnosanitetski pregled T1 - Reconstructive surgery of an extremely calcified mitral valve in a Barlow disease patient: A case report T1 - Rekonstruktivna hirurgija ekstremno kalcifikovane mitralne valvule kod bolesnika sa Barlovljevom bolesti VL - 76 IS - 5 SP - 552 EP - 554 DO - 10.2298/VSP170312117S ER -
@article{ author = "Stojanović, Ivan and Kaitović, Marko and Novaković, Aleksandra and Vuković, Petar", year = "2019", abstract = "Introduction. Mitral valve calcifications are frequent finding in Barlow disease. This is making mitral repair surgery even more demanding in already complex valve pathology. Case report. A fifty-five-year-old Barlow disease patient underwent a mitral repair surgery due to posterior leaflet prolapse at P2 level and extensive posterior leaflet and annular calcifications as well. The prolapsed scallop was resected, while P1 and P3 scallops were detached from the annulus. After complete posterior annulus decalcification, so formed the large atrio-ventricular defect was reconstructed with the autologous pericardial patch and double suture line technique. The P1 and P3 segments were reattached there by the sliding technique and sutured with no strain. Annuloplasty was performed with a saddle rigid ring No 36. The patient was discharged nine days after the surgery with just a trace of mitral regurgitation. Conclusion. Annular decalcification and reconstruction in the patients with calcified Barlow mitral disease is necessary for safe and durable mitral valve surgical repair., Uvod. Kalcifikacije mitralne valvule su čest nalaz kod bolesnika sa Barlovljevom bolesti što čini rekonstruktivnu hirurgiju zalistka kod ovih bolesnika znatno složenijom. Prikaz bolesnika. Bolesniku starom 55 godina je urađena rekonstrukcija mitralnog zalistka zbog prolapsa posteriornog listića i značajnih kalcifikacija na P2 segmentu i posteriornom anulusu. Nakon resekcije P2 segmenta i odvajanja P1 i P3 segmenta od anulusa, urađena je kompletna resekcija velikog kalcifikata sa skoro polovine obima posteriornog anulusa. Nastali atrioventrikularnog defekt rekonstruisan je autolognim perikardom elipsoidnog oblika sašivenim u dva sloja. P1 i P3 segment su potom reinplantirani na rekonstruisani anulus i međusobno spojeni. Rekonstruktivna procedura je kompletirana anuloplastikom pomoću sedlastog rigidnog prstena veličine 36. Bolesnik je otpušten devetog postoperativnog dana sa neznatnom mitralnom regurgitacijom. Zaključak. Dekalcifikacija posteriornog anulusa uz preciznu rekonstrukciju nastalog atrioventikularnog defekta je neophodna procedura za bezbednu i funkcionalno trajnu rekonstrukciju mitralnog zalistka.", publisher = "Vojnomedicinska akademija - Institut za naučne informacije, Beograd", journal = "Vojnosanitetski pregled", title = "Reconstructive surgery of an extremely calcified mitral valve in a Barlow disease patient: A case report, Rekonstruktivna hirurgija ekstremno kalcifikovane mitralne valvule kod bolesnika sa Barlovljevom bolesti", volume = "76", number = "5", pages = "552-554", doi = "10.2298/VSP170312117S" }
Stojanović, I., Kaitović, M., Novaković, A.,& Vuković, P.. (2019). Reconstructive surgery of an extremely calcified mitral valve in a Barlow disease patient: A case report. in Vojnosanitetski pregled Vojnomedicinska akademija - Institut za naučne informacije, Beograd., 76(5), 552-554. https://doi.org/10.2298/VSP170312117S
Stojanović I, Kaitović M, Novaković A, Vuković P. Reconstructive surgery of an extremely calcified mitral valve in a Barlow disease patient: A case report. in Vojnosanitetski pregled. 2019;76(5):552-554. doi:10.2298/VSP170312117S .
Stojanović, Ivan, Kaitović, Marko, Novaković, Aleksandra, Vuković, Petar, "Reconstructive surgery of an extremely calcified mitral valve in a Barlow disease patient: A case report" in Vojnosanitetski pregled, 76, no. 5 (2019):552-554, https://doi.org/10.2298/VSP170312117S . .