case_images: PMC11303175_01
case_images: (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.
case_images: fcvm-11-1425900-g001.jpg
case_images: PMC11303175_01_fcvm-11-1425900-g001.jpg
case_images: F1
case_images: A 3-month-old male infant, 5.35 kg, was diagnosed with severe MS and MR via transthoracic echocardiography (Figures 1A,B). To address these conditions, the patient underwent a complex mitral valvuloplasty procedure under anesthesia (Figure 1C). Subsequent postoperative echocardiography revealed worsening MR with extensive regurgitation (Figure 1D). A freshly harvested aortic valve from another pediatric heart transplant recipient was preserved at 4 C in an antibiotic-containing culture medium for 10 days and used for this procedure (Figure 1E, left). The allogeneic aortic valve was anastomosed to the mitral annulus utilizing the Top-Hat technique (Figure 1E, right). Remarkably, the patient was successfully weaned off ECMO support immediately after surgery, and postoperative echocardiography confirmed a reduction in MR to a trace amount (Figure 1F).