Figure legends:
Figure 1 A-C. Preoperative thorax CT-scan showing the previously implanted prosthetic mitral valves (red arrows) and the surrounding extensive annular calcification (yellow arrows). Atransversal view, B coronal view, C sagittal view.Ao Aorta, LA left atrium, LV left ventricle,PA pulmonary artery, RA right atrium, RVright ventricle, SVC superior vena cava.
Figure 2 A–C Degenerated mitral “valve-in-valve” prostheses. Note the severe stenosis demonstrated by the inability of the leaflets to sufficiently open (yellow arrow). A lateral view, Bview from ventricular aspect, C view from atrial aspect.Figure 2D Calcified tissue removed during operation.
Figure 3. Mechanical valve (yellow arrow), bovine pericardial patch for reconstruction of the posterior aspect of the mitral annulus (blue arrow).