Reconstruction of the Mitral Annulus With Porcine Pericardium Report of a Case With Mitral Annular Disruption due to Staphylococcal Endocarditis

Shigeaki Aoyagi; Shuji Fukunaga; Atsushige Oryoji; Kenichi Kosuga; Seiji Kanaya; Masanao Ouchida; Kazunori Kuwano; Teruo Sakamoto

doi:10.1253/jcj.60.258

Case Report

Reconstruction of the Mitral Annulus With Porcine Pericardium

Report of a Case With Mitral Annular Disruption due to Staphylococcal Endocarditis

Shigeaki Aoyagi, Shuji Fukunaga, Atsushige Oryoji, Kenichi Kosuga, Seiji Kanaya, Masanao Ouchida, Kazunori Kuwano, Teruo Sakamoto

Author information

Shigeaki Aoyagi
Second Department of Surgery, Critical Care Center, Kurume University School of Medicine
Shuji Fukunaga
Second Department of Surgery, Critical Care Center, Kurume University School of Medicine
Atsushige Oryoji
Second Department of Surgery, Critical Care Center, Kurume University School of Medicine
Kenichi Kosuga
Second Department of Surgery, Critical Care Center, Kurume University School of Medicine
Seiji Kanaya
Second Department of Surgery, Critical Care Center, Kurume University School of Medicine
Masanao Ouchida
Second Department of Surgery, Critical Care Center, Kurume University School of Medicine
Kazunori Kuwano
Second Department of Surgery, Critical Care Center, Kurume University School of Medicine
Teruo Sakamoto
Second Department of Surgery, Critical Care Center, Kurume University School of Medicine

Keywords: Infective endocarditis, Mitral annular disruption, Mitral annular reconstruction, Staphylococcus aureus

JOURNAL FREE ACCESS

1996 Volume 60 Issue 4 Pages 258-261

DOI https://doi.org/10.1253/jcj.60.258

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Abstract

A 60-year-Old man was admitted to our hospital for investigation of dyspnea and disorientation with right hemiplegia. Echocardiography showed thickened mitral valve leaflets with vegetations and severe mitral regurgitation. Blood cultures grew Staphylococcus aureus. During the operation, perforation and destruction of the mitral valve leaflets and vegetations were confirmed. Debridement of the infected tissues resulted in segmental disruption of the posterior mitral fibrous annulus. Reconstruction of the mitral annulus with porcine pericardium treated with glutaraldehyde and mitral valve replacement were successful. The patient's postoperative course was complicated with metastatic cerebral and splenic abscesses. After splenectomy on the 8th postoperative day, he gradually recovered without major neurologic sequelae. We believe that reconstruction of the mitral valve annulus with pericardium, especially autologous pericardium, is reliable and useful for the treatment of patients with disruption of the mitral valve annulus. (Jpn Circ J 1996; 60: 258 - 261)

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