Case Report: Allograft aortic valve replacement in irreparable infant mitral valve

Abstract

This case report describes a 3-month-old male infant diagnosed with severe mitral stenosis (MS) and mitral regurgitation (MR) by transthoracic echocardiography. The male infant initially underwent complex mitral valve repair surgery. However, postoperative deterioration occurred with hemodynamic instability and shock, necessitating multiple resuscitation efforts and ultimately requiring support from Extracorporeal Membrane Oxygenation (ECMO). Given the serious conditions, the cardiac team decided to perform mitral valve replacement with a fresh allograft aortic valve. Postoperatively, the patient was promptly weaned off ECMO support, and the valve demonstrated sustained functionality throughout the long-term follow-up.

Keywords: allograft aortic valve; infants; mitral regurgitation (MR); mitral valve disease; mitral valve repair.

Figure 1

(A) Transthoracic echocardiography (TTE) demonstrating mitral stenosis in conjunction with severe closure insufficiency. (B) TTE demonstrated severe mitral regurgitation before surgery. (C) This image shows a complex mitral valve repair in operation. (D) Postoperative TTE showed moderate mitral regurgitation. (E) Left: This figure shows a trimmed fresh allograft aortic valve. Right: This figure illustrates the implantation of a fresh allograft aortic valve in the mitral position using the Top-hat method. (F) Postoperative TTE shows a well-suited and well-functioning mitral valve with mild mitral regurgitation following allograft aortic valve (arrow) replacement.