ORCID
0009-0007-8448-9999 (Agarwal)
Document Type
Article
Publication Date
2026
DOI
10.21542/gcsp.2026.13
Publication Title
Global Cardiology Science and Practice
Volume
2026
Issue
2
Pages
1-5
Abstract
Introduction: LVOT obstruction after surgical bioprosthetic MVP placement is uncommon and the influence of the MVP strut width has seldom been examined.
Case presentation: A 74-year-old female presented with palpitations, chest pain, and shortness of breath. She had MVR with 31-mm bioprosthetic valve 2 years prior. TEE confirmed LVOT obstruction secondary to a MVP strut, causing a peak gradient of 55 mmHg. The redo operation was complicated by iatrogenic Type A aortic dissection. The patient was immediately cooled for DHCA with RCP and ascending aortic replacement was performed. MVR was then performed with a prosthesis with narrower strut width. Recovery after surgery was uneventful and post-bypass TEE confirmed absence of LVOT obstruction (gradient of 4 mmHg).
Discussion: This case is of interest for two reasons. Primarily, the overall profile of the valve, including the width of the struts may play a significant role in the development of LVOT obstruction after MVR. Additionally, the patient had an ITAAD requiring prompt and thoughtful management.
Conclusions: This case underscores the importance of evaluating MVP profile in relation to patient anatomy. Furthermore, intraoperative Type A aortic dissection is a rare but lethal phenomenon requiring swift decision-making and technical ability, and both are important considerations for trainees.
Rights
Copyright © 2026 Rishab Agarwal, AlleaBelle Bradshaw, Michelle Carvajal, Jennifer Lawton.
This work is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) License.
Original Publication Citation
Agarwal, R., Bradshaw, A., Carvajal, M., & Lawton, J. S. (2026). Complicated third sternotomy for left ventricular outflow tract obstruction secondary to mitral valve prosthesis strut. Global Cardiology Science and Practice, 2026(2), 1-5, Article e202613. https://doi.org/10.21542/gcsp.2026.13
Repository Citation
Agarwal, R., Bradshaw, A., Carvajal, M., & Lawton, J. S. (2026). Complicated third sternotomy for left ventricular outflow tract obstruction secondary to mitral valve prosthesis strut. Global Cardiology Science and Practice, 2026(2), 1-5, Article e202613. https://doi.org/10.21542/gcsp.2026.13