Conduit-on-valve replacement of a degenerated mitral bioprosthesis with a bioprosthesis  Jen-Ping Chang, MD, Chiung-Lun Kao, MD, Kuei-Ton Tsai, MD, Ming-Jang.

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Conduit-on-valve replacement of a degenerated mitral bioprosthesis with a bioprosthesis  Jen-Ping Chang, MD, Chiung-Lun Kao, MD, Kuei-Ton Tsai, MD, Ming-Jang Hsieh, MD, Morgan Fu, MD  The Annals of Thoracic Surgery  Volume 75, Issue 6, Pages 1987-1989 (June 2003) DOI: 10.1016/S0003-4975(02)04658-1

Fig 1 The bioprosthesis–Dacron tube conduit was completed with the bovine pericardial strip covering all Dacron surfaces, with the smooth surface out. The Annals of Thoracic Surgery 2003 75, 1987-1989DOI: (10.1016/S0003-4975(02)04658-1)

Fig 2 Drawing of the conduit-on-valve mitral re-replacement. All degenerated leaflet tissue is removed (arrow), and the bioprosthesis–Dacron tube composite graft is apposed to the inflow aspect of the previous bioprosthetic stent. The Annals of Thoracic Surgery 2003 75, 1987-1989DOI: (10.1016/S0003-4975(02)04658-1)

Fig 3 Intraoperative appearance of the completed bioprosthesis–Dacron tube conduit mitral re-replacement. The composite graft sits on the atrial aspect of the previous bioprosthetic stent. The Annals of Thoracic Surgery 2003 75, 1987-1989DOI: (10.1016/S0003-4975(02)04658-1)

Fig 4 Transthoracic echocardiography 3 months postoperatively showing the mitral conduit-on-valve with valve area of 2.69 cm2. The Annals of Thoracic Surgery 2003 75, 1987-1989DOI: (10.1016/S0003-4975(02)04658-1)

Fig 5 Transthoracic echocardiography showing the mitral conduit-on-valve bioprosthesis projecting into the left atrium without any thrombus formation 6 months postoperatively without anticoagulation. The Annals of Thoracic Surgery 2003 75, 1987-1989DOI: (10.1016/S0003-4975(02)04658-1)