A case of an explanted 26-year-old Carpentier-Edwards supra-annular valve in the tricuspid position
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文摘
Whether a mechanic or bioprosthetic valve is better for tricuspid valve replacement is still controversial. One problem of bioprostheses is structure valve deterioration. However, a bioprosthesis in the tricuspid position is more durable than that in the aortic and mitral positions. We report a case of an explanting Carpentier-Edwards supra-annular valve (CE-SAV) (Baxter Healthcare Corp., Irvine, CA, USA) in tricuspid position 26 years after tricuspid valve replacement. A 36-year-old female underwent total correction of tetralogy of Fallot at the age of five, and three years later she underwent tricuspid valve replacement for severe tricuspid regurgitation using a Björk-Shiley valve. Two years later, the mechanical valve was explanted due to thrombus formation, and a 29-mm CE-SAV was implanted in tricuspid position. Twenty-six years after implantation, we explanted the valve due to structural valve deterioration. The leaflets of the valve were hard and stiff, and calcifications were present on all the leaflets. A small tear existed in the part of most calcified leaflet. To the best of our knowledge, this is the longest durability of CE-SAV in tricuspid position.<Learning objective: Whether bioprosthetic or mechanical valve should be chosen for tricuspid valve replacement is still controversial. A bioprosthesis in the tricuspid position is more durable than that in the aortic or mitral position. We explanted the valve due to structural valve deterioration 26 years after implantation. The leaflets were hard and stiff, and calcifications were present on all the leaflets. A small tear existed in the part of most calcified leaflet.>

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