Percutaneous Management of a Mechanical Complication Post Mitral Valve Surgery in a Child.

A 4-year-old girl with congenital mitral regurgitation status post mechanical mitral valve replacement (MVR) using a 16 mm Carbomedics valve (LivaNova) at the age of 5 months underwent a redo MVR using a 21 mm aortic prosthesis implanted in an inverted position for progressed increased mitral valve gradient due to pannus formation. Post operatively, echocardiogram showed good mitral valve prosthesis function with severe depressed left ventricular function (ejection fraction, 19%) and markedly segmental dyskinesia in the lateral wall. Her diagnosis of compression to the proximal dominant left circumflex artery and subsequent percutaneous coronary intervention are outlined here.