Repeat tricuspid valve replacement for acquired valvular heart disease: report of a case.

A patient was admitted to our hospital for investigation of exertional dyspnea and liver dysfunction, 10 years after undergoing mitral valve replacement (MVR) and tricuspid valve replacement (TVR) using a Bjork-Shiley mechanical valve and a Carpentier-Edwards bioprosthesis, respectively. Echocardiographic examinations, magnetic resonance imaging (MRI), and cardiac catheterization subsequently revealed severe degenerative changes of the artificial tricuspid valve. Thus, a repeat TVR with plication of his enlarged right atrium that was compressing the right lung was performed. The extracorporeal circulation was adjusted so that the oxygen saturation of the hepatic vein was maintained above 50% to prevent liver damage. The patient had a good postoperative course and has encountered no further problems since his discharge from hospital.