Mitral disc-valve variance.

This report deals with a rare complication of disc-valve prosthesis in the mitral area. A significant disc poppet and struts destruction of mitral BeaU valve prostheses occurred 20 and 17 months after implantation. The resulting valve incompetence in the first case contributed to the death of the patient. The durability of Teflon prosthetic valves appears to be in question and this type of valve probably will be unacceptable if there is an increasing number of disc-valve variance in the future. The majority of the prosthetic devices used to A B replace the heart valve have been used with success. Our experience during the last decade has been gratifying in that more than 65% of our patients have been relieved of their symptoms and are living relatively normal lives. However, in spite of the great convenience of rigid prosthetic heart valves, their use has also been fraught with both early and late complications. In the search for an ideal mitral prosthesis, the concept of a low-profile disc-valve was introduced by several cardiac surgeons. So far the clinical use of this kind of valve has been rewarding. 0 cm i 3 i 5 The incidence of disc variance in the mitral FIG. 1. (A) Case 1. A large size Beall valve disc remov the disc edge are seen. (B) Case 2. Medium size Beall val and Greenberg, 1971). This report deals with two disc. cases that had significant erosions of both the disc poppet and struts of a mitral Beall valve prosthesis. We feel that the resulting valve incompetence contributed to the death of case 1. CASE REPORTS CASE 1 A 42-year-old white man had a mitral and aortic valve replacement on 24 May 1968 for rheumatic heart disease, severe mitral and aortic insufficiency, and congestive heart failure. He was classified functionally as IV-D (New York Heart Association). The diseased mitral valve was replaced , with a large size mitral Beall prosthesis and the aortic valve was replaced with a No. 11 Starr-Edwards aortic prosthesis. Initially after operation the patient had a good result but 10 months later he developed intractable congestive heart failure. A systolic murmur was detected at the apical area. The sound of the aortic and mitral prosthesis was clear and FIG. 2. Disc in situ showing equidistant deep notches a) crisp. There was evidence of haemolysis although its relation to the vertical struts. The struts were slight he …