Prosthetic Mitral Valve Replacement

This patient developed rheumatic fever as a teenager living in Mexico City . After moving to Chicago , he began experiencing exertional breathlessness which progressed to the point that he could no longer walk up 1 flight of stairs without panting. Later, atrial fibrillation developed and he was started on coumadin . 6 months after initially presenting with shortness of breath, he was admitted with congestive heart failure and a diagnosis of rheumatic heart disease was made after echocardiography and cardiac catheterization were performed. These studies indicated the presence of stenosis (narrowing) and regurgitation (leakiness) across the mitral valve separating the left atrium from the left ventricle. Coronary artery blockages were also identified and he underwent combined coronary artery bypass surgery and mitral valve replacement with a mechanical valve shown above. The angiogram above was taken when he presented to the hospital 5 years after his original surgery with chest pain. The valve is working normally but he developed a blockage in one of his vein bypass grafts which was successfully treated with stenting .