Reversely Implant Carbomedics Mechanical Aortic Prosthesis In Mitral Valve Replacement In Patients With Small Mitral Annulus

Objectives:Through the review of3patients of rheumatic mitral stenosis with small annulus, we introduce a new method of reversely implanting Carbomedics mechanical aortic prosthesis in Mitral valve replacement(MVR).Methods:Between January2010to December2011,3patients with rheumatic mitral stenosis underwent reverse implantation of Carbomedics Aortic prosthesis during mitral valve replacement, due to extremely small mitral annulus found during the operation. We retrospectively review the history, surgical find and surgical procedure, pre-and post-operative ultrasonic exam and early outcome of these3patients.Results:3patients underwent Mitral valve replacement+Tricuspid Valve Annuloplasty, Mitral valve replacement and Mitral valve replacement+Aortic valve replacement, respectively. We all use23#Carbomedic Aortic prosthesis to place in the mitral position with reverse implant technique. Average bypass time is99min (105,80,110min) average cross-clamp time is48min (60,35,50min), postoperative mean pressure gradients is7.2mmHg(11.6,4,6.2mmHg). No deaths and other severe complications happened both before discharge and6month after the operation. Follow up showed all3patients with cardiac function of NYHA Ⅱ.Conclusion:When confronted with extremely small mitral annulus, it is a feasible way to apply reverse implantation of Carbomedics aortic prosthesis in mitral valve replacement. Long term prognosis still need further follow up.