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Ann Thorac Surg 2008;86:1696. doi:10.1016/j.athoracsur.2007.08.009
© 2008 The Society of Thoracic Surgeons
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Baris Caynak
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Images in Cardiothoracic Surgery

Migration of a Rigid Mitral Valve Ring

Ilhan Sanisoglu, MDa,*, Liva Ertan Sagbas, MDa, Cihan Duran, MDb, Baris Caynak, MDa, Tahsin Belhhan Akpinar, MDa

a Department of Cardiovascular Surgery, Medical Faculty of Istanbul Science University, Istanbul, Turkey
b Department of Radiology, Medical Faculty of Istanbul Science University, Istanbul, Turkey

* Address correspondence to Dr Sanisoglu, Abidei Hurriye Cad No 290, Cagla Yan, Istanbul, 80920, Turkey (Email: isanisoglu{at}hotmail.com).

A 72-year-old man with a previous history of open heart surgery was admitted with dyspnea and fatique. He had undergone mitral valve repair with a rigid annuloplasty ring 5 years prior. The chest x-ray film and computed tomographic scan showed the mitral valve ring within the aortic arch located just distally to the innominate artery (Fig 1). There was no indication of endocarditis in the patient's history, and mitral valve regurgitation was not present on previous echocardiocraphic studies.


Figure 1
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  		Fig 1.
 
Surgery was performed electively. The mitral valve ring was removed through the aortotomy incision near the aortic arch using a short period of total circulatory arrest. The mitral valve was replaced during the rewarming period. The stitches on the removed ring suggested that it was sewed using an interrupted suture technique and the reason of dehisence is unclear (Fig 2). The patient was discharged without any adverse event.


Figure 2
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  		Fig 2.
 





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