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Redo mitral valve replacement using valve-on-valve technique in a patient with severe posterior mitral annular calcification
  1. Adil H Al Kindi,
  2. Ahmed Fahmy Mandisha,
  3. Mohamed Hammam and
  4. AbdelMaged Salem
  1. Cardiothoracic Surgery, Sultan Qaboos University Hospital, Al Khod, Oman
  1. Correspondence to Dr Adil H Al Kindi; adilalkindi{at}


Redo mitral valve replacement surgery due to bioprosthetic valve failure can carry serious surgical challenges. In addition to the usual redo sternotomy risk, there is risk of circumflex coronary artery injury or atrioventricular disruption from explanting the prosthesis. Alternatives to prosthesis explantation may be needed in some cases.

We report a case of mitral bioprosthetic valve failure in a young patient who had a history of atrioventricular disruption during the first surgery and had pericardial patch repair of the defect. The risk of explanting the bioprosthesis during redo surgery was very high. Therefore, we performed valve replacement using valve-on-valve technique in which the new valve is implanted within the sewing ring of the previous bioprosthesis without explanting the valve. This technique converted a very highly futile surgery to a conventional redo surgery risk. The patient had a successful surgery with no intraoperative or postoperative complications.

  • valvar diseases
  • radiology (diagnostics)
  • surgical diagnostic tests
  • clinical diagnostic tests
  • radiology

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  • Contributors All authors contributed to the care of the patient. AHAK and AFM collected data and wrote the manuscript. MH and AS prepared the figures and captions. All authors reviewed and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.