RESUMO
Eclipsed mitral regurgitation is a relatively new disease concept reported in recent years, of which is not fully elucidated. A 73-year-old female had repeated episodes of heart failure of unknown cause. During cardiac catheterization and echocardiography performed, mitral regurgitation suddenly worsened and improved in a few minutes. The patient was diagnosed as having eclipsed mitral regurgitation with multiple episodes of acute exacerbation and remission. Although mechanism of exacerbation remains unclear, morphological change of the left ventricle is likely to be a major cause, and mitral valve replacement seems better than plasty for prevention of recurrent heart failure. The patient underwent valve replacement using a bioprothesis and was discharged from the hospital on her own 24 days after surgery. Six months after the operation, she has been doing well without recurrence of heart failure.
Assuntos
Insuficiência Cardíaca , Implante de Prótese de Valva Cardíaca , Insuficiência da Valva Mitral , Idoso , Feminino , Humanos , Cateterismo Cardíaco , Ecocardiografia , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/cirurgia , Próteses Valvulares Cardíacas , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/complicações , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/cirurgia , Recidiva , Remissão EspontâneaRESUMO
Aortic valve replacement using CEP Magna 21 mm bioprosthetic valve was performed because of aortic valve stenosis in a 75-year-old man with maintenance dialysis. In the 39th postoperative month, the bioprosthetic valve malfunction due to calcification was noted, and it was replaced. Judging from the previously reported cases, malfunction of an artificial valve in the 39th month is thought to be relatively early. Early-stage calcification of a bioprosthetic valve is considered to be caused by secondary hyperparathyroidism due to artificial dialysis. Therefore, careful consideration is necessary in selecting an artificial valve in a dialysis patient. To prevent early-stage calcification of a bioprosthetic valve in a dialysis patient, strict control of parathyroid hormones, blood phosphorus and calcium levels is necessary. In addition, due to the attendant risk of calcification of bioprosthetic valves, mechanical valves are recommended to dialysis patients, who are expected to survive for more than 3 years and who are not expected to develop hemorrhagic complications.