Redo mitral valve replacement using valve-on-valve technique in a patient with severe posterior mitral annular calcification

Adil H. Al Kindi*, Ahmed Fahmy Mandisha, Mohamed Hammam, Abdelmaged Salem

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Redo mitral valve replacement surgery due to bioprosthetic valve failure can carry serious surgical challenges. In addition to the usual redo sternotomy risk, there is risk of circumflex coronary artery injury or atrioventricular disruption from explanting the prosthesis. Alternatives to prosthesis explantation may be needed in some cases. We report a case of mitral bioprosthetic valve failure in a young patient who had a history of atrioventricular disruption during the first surgery and had pericardial patch repair of the defect. The risk of explanting the bioprosthesis during redo surgery was very high. Therefore, we performed valve replacement using valve-on-valve technique in which the new valve is implanted within the sewing ring of the previous bioprosthesis without explanting the valve. This technique converted a very highly futile surgery to a conventional redo surgery risk. The patient had a successful surgery with no intraoperative or postoperative complications.

Original languageEnglish
Article numbere243527
JournalBMJ Case Reports
Issue number7
Publication statusPublished - Jul 21 2021
Externally publishedYes


  • clinical diagnostic tests
  • radiology
  • radiology (diagnostics)
  • surgical diagnostic tests
  • valvar diseases

ASJC Scopus subject areas

  • Medicine(all)

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