Department of Cardiology, St. Luke's University Health Network, Bethlehem, PA, USA.
Department of Cardiothoracic Surgery, St. Luke's University Health Network, Bethlehem, PA, USA.
Echocardiography. 2020 Apr;37(4):637-640. doi: 10.1111/echo.14634. Epub 2020 Mar 17.
We report commissural fusion as a unique morphologic etiology of early bioprosthetic mitral valve failure in a woman with a history of rheumatic mitral stenosis. She had undergone mitral valve replacement with a 25-mm Edwards Magna Ease bovine pericardial bioprosthesis 3 years earlier and presented with progressive dyspnea. Transesophageal echocardiography revealed severe bioprosthetic stenosis due to commissural fusion. She underwent percutaneous valve-in-valve implantation with a 26-mm Edwards Sapien 3 prosthesis. Marked symptomatic improvement was noted postprocedurally. We speculate that commissural fusion may be a unique pathologic feature of failing bioprosthetic valves in patients with prior rheumatic mitral valve disease.
我们报告了一例因风湿性二尖瓣狭窄而接受二尖瓣置换术的女性，其早期生物瓣失败的独特形态学病因是连合融合。患者 3 年前曾接受 25mm 爱德华兹 Magna Ease 牛心包生物瓣置换术，现出现进行性呼吸困难。经食管超声心动图显示严重的生物瓣狭窄，原因是连合融合。患者接受了经皮瓣中瓣植入术，植入了 26mm 爱德华兹 Sapien 3 生物瓣。术后症状明显改善。我们推测，连合融合可能是既往风湿性二尖瓣病变患者生物瓣失效的一个独特的病理特征。
