LATE VALVE DYSFUNCTION AFTER IMPLANTATION OF A MECHANICAL MITRAL-VALVE PROSTHESIS

14 years after a Bjork-Shiley prosthesis had been implanted because of combined mitral failure, a 68-year-old woman complained of progressiv e decrease of physical powers combined with apnoea, retrosternal feeli ng of pressure and tachycardial atrial fibrillation. Five weeks later, onset of cardiac decompensation with dyspnoea at rest and signs of co ngested pulmonary circulation were noted. Echocardiography revealed st enosis of the mitral valve prosthesis. The patient was operated on two days later. It became evident that the patency of the prosthesis was greatly obstructed by connective tissue which had proliferated at the ventricular side. The original valve prosthesis was replaced by a St. Jude bi-leaflet valve. - The likelihood of prosthesis dysfunction must always be considered if there is a deterioration in the patient's con dition after a long uncomplicated postoperative course following cardi ac valve replacement.