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Interesting Case Of Treating Rheumatic Mitral Stenosis Tmvr Valve In Valve
Attaullah K. Niazi1, Mohammad Sharif Nassery
2;
1King Edward Medical University, Lahore, Pakistan,
2French Medical institute for Mothers and children, kabul, Afghanistan
Background / Study Objective Degenerated restenosed MS inrelatively young patient is a unique problem of developing anddeveloped countires where rhematic heart disease used to besignificant problem Valve in valve TMVR is a well standardisedprocedure now in experienced center CT scan analysis to defineNeo-LVOT and septal angles is very important Adequate planning
Patients 70 years gentleman, Severe COPD, HTN Rheumatic heartdisease with two procedure in past Open mitral commissurotomy1990 Mitral valve replacement 2007 ( Tissue valve Magna 25mm ) Now has severe heart failure, Bilateral pleural ef`usion, Echo showedDegenerated tissue valve with severe re-stenosis, Severe PAH, RVdysfunction Very high risk for an open heart surgery due to currentheart failure and two previous heart surgery
METHODS: 3D TEE - Severely degenerative bioprosthesis ED Echo -degenerative tissue valve CT Feasibility analysis for TMVR - with 26mm Myval in 25 Magna
RESULTS:
Transeptal punctureseptal puncture location - Important Valvedeployed very slowly under rapid pacing
CONCLUSIONS:
Quick recovery Patient extubated on table Pre- op mitralgradient - 40/23 mmHg, Post op mitral gradient - 4/2mmHg Discharged on 2nd POD Now doing well, 18 month follow u
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