2023-09-09 08:37:03
by Gianluca Polvani
After an operation, years later it may happen that the valve no longer works correctly or blood passes between the perimeter of the mechanical prosthesis and the aortic annulus.
I have a mechanical mitral valve, an operation I underwent more than twenty years ago. In the last year I have often resorted to transfusions due to lowering of hemoglobin, due to hemolysis caused by the valve. They offered me the possibility of replacing the valve, although I was convinced that the mechanical valve would last forever. This has been a cold shower for me and I’m very undecided about what to do. What do you suggest me?
Answered by Gianluca Polvani, Director of the Department of Cardiovascular Surgery, Monzino IRCCS Cardiology Center in Milan (VAI AL FORUM)
It’s true that mechanical valves normally last a lifetime; Unfortunately, however, sometimes adverse events may appear which compromise its correct function and this leads to an increase in the possibility of haemolysis.
If your valve has functioned correctly over the years and, instead, haemolysis has recently appeared, there could be essentially two problems: either the valve no longer works correctly, or blood passes between the perimeter of the mechanical prosthesis and the aortic annulus (paravalvular leak ).
Unfortunately, I confirm that in both cases, if you have already undergone several transfusions, there is an indication to re-replace the aortic valve in case of valve dysfunction. If it is a leak, however, in a small percentage of cases it is possible to intervene on the problem endovascularly, otherwise in this case too there is a need for re-intervention.
In order to know the test, it is necessary to perform a transesophageal echocardiogram.
September 9, 2023 (changed September 9, 2023 | 08:30)
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