Botched Heart Valve Repair Procedure Leads to Patient Death

ByJoseph O'Neill

|

Updated onJanuary 18, 2018

Botched Heart Valve Repair Procedure Leads to Patient Death

This case involves a middle-aged female patient who underwent a mitrial valve repair and replacement surgery. The surgery was conducted without incident, however shortly after the patient’s recovery began she began suffering from mitral stenosis, which was later attributed to an issue with the sizing and / or placement of the valve. Eventually, the patient also suffered a lethal stroke, which was believed to be a result of the mitrial valve operation.

Question(s) For Expert Witness

1. How often do you perform mitral valve replacement?

2. Do you do transcatheter procedures?

Expert Witness Response E-107122

inline imageOver-correction of mitral regurgitation is a well described issue complicating mitral valve repair. It occurs most often when the annuloplasty ring is undersized, which can be intentional in repairs performed for regurgitation secondary to cardiomyopathy or ischemic mitral regurgitation. Sometimes it can be the result of maneuvers used for more complex repairs, like an Alfieri stitch when used as a bailout. The key moment is immediately upon coming off bypass after a repair, when the trans esophageal echocardiographer (usually the anesthesiologist, sometimes a cardiologist invited to the OR) measures velocity through the repaired valve to determine the gradient across the valve. Anything above 5 mmHg makes me leery, and might prompt me to go back on pump and perform a chordal sparing valve replacement, if the extra time on pump doesn't seem too dangerous. I perform mitral valve replacements and repairs fairly regularly, about 5 cases a month. I evaluate patients regularly for catheter based procedures for the mitral valve as a member of our Structural Heart Disease center.

About the author

Joseph O'Neill

Joseph O'Neill

Joe has extensive experience in online journalism and technical writing across a range of legal topics, including personal injury, meidcal malpractice, mass torts, consumer litigation, commercial litigation, and more. Joe spent close to six years working at Expert Institute, finishing up his role here as Director of Marketing. He has considerable knowledge across an array of legal topics pertaining to expert witnesses. Currently, Joe servces as Owner and Demand Generation Consultant at LightSail Consulting.

Find an expert witness near you

What State is your case in?

What party are you representing?