An alternate approach to valve replacement in patients with mitral stenosis and severely calcified annulus.

Abstract

A severely calcified mitral annulus represents a unique challenge during mitral valve replacement. To ensure proper healing of the sewing ring of the prosthesis and to avoid periprosthetic regurgitation, the mitral annulus often must be debrided for secure attachment. However, the extensive debridement that can be required in some cases could increase the risk of atrioventricular groove disruption, with a subsequent increase in morbidity and mortality. Bypass of the mitral valve with a left atrial to left ventricular-valved conduit has been described for difficult cases with congenital mitral valve stenosis. In our report, we describe its use as a safe alternative to standard mitral valve replacement in a patient with a densely calcified annulus and severe mitral stenosis.