Harvey S. Hahn, MD; Seymour S. Maze, MB, ChB
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Hahn HS, Maze SS. Rapid Bioprosthetic Valve Degeneration in a Patient Undergoing Hemodialysis. Ann Intern Med. 2000;132:847. doi: 10.7326/0003-4819-132-10-200005160-00033
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Published: Ann Intern Med. 2000;132(10):847.
TO THE EDITOR:
A 76-year-old man who was undergoing hemodialysis had aortic valve replacement for calcific aortic stenosis. Stenosis was performed by using a 25-mm Carpentier–Edwards porcine valve. Heart failure recurred 20 months later. Cardiac catheterization confirmed significant prosthetic stenosis with a calculated aortic valve area of 0.6 cm2. There was no evidence of hyperparathyroidism. The patient underwent a second aortic valve replacement with a St. Jude mechanical valve. At surgery, the bioprosthetic valve was found to be heavily calcified, with fusion of the leaflets.
Native cardiac calcification is a well-known consequence of chronic renal failure. Only two reports in the English-language literature (1, 2) have described early bioprosthetic valve failure in patients undergoing dialysis. The extremely rapid calcific degeneration of the bioprosthesis in our case is striking.
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