Late outcome of mitral valve replacement with the Cross-Jones prosthesis 36 years after initial surgery.

A 60 year-old woman with rheumatic mitral stenosis underwent re-replacement of Cross- Jones caged lens mitral valve prosthesis, 36 years after valve implantation. In 1968, she underwent mitral commissurotomy. In 1992, she had a stroke, and in July 2009 echocardiography revealed the malfunction of the prosthesis with pannus and reduced mitral prosthetic area < 1.0 cm(2) with the elevated transprosthetic gradient of 30 mm Hg. To begin with, she did not approve of the reoperation. Finally, she consented to this therapeutic option. In October 2009 Medtronic prosthesis Advantage 27 was re-implanted. We report the longest period of working Cross-Jones mitral valve in the literature.