Cautionary Tale of Failed Mitral Valve Replacements

This case report discusses the tragic outcome of a young female patient in her early 50s with rheumatic heart disease (RHD) who underwent multiple mitral valve replacements. Initially diagnosed with mitral valve prolapse at age 12, she received a bioprosthetic mitral valve replacement (bMVR) 26 years later, which degenerated after 13 years, leading to severe mitral regurgitation and stenosis. ​ A complex redo surgery with mechanical mitral valve replacement (mMVR) and tricuspid valve repair was performed but was complicated by multi-organ failure, paravalvular leak, and therapy-resistant conditions, ultimately resulting in her death. ​ The report highlights the challenges of managing valvular dysfunction in RHD, the importance of regular follow-ups, and the need for multidisciplinary approaches to improve outcomes in such complex cases. ​