The ramifications of a complex mitral valve repair surgery left an elderly schoolteacher with postoperative valve stenosis, leading to tricuspid valve insufficiency and multiple other conditions causing a congestive heart failure. The ensuing court case over the operation’s outcome alleged that the surgeon had not performed an intraoperative or postoperative echocardiogram, leaving his patient open to unforeseen consequences during surgery. Additionally, the patient claimed that his mitral valve stenosis had not been identified by the surgeon for nearly eight months following the procedure. The case asked cardiovascular and cardiothoracic surgeons to review the schoolteacher’s case and comment on any notable elements of patient management and standard of care.
Question(s) For Expert Witness
- 1. Please describe the extent to which you have managed similar patients and performed mitral valve surgeries.
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2. What elements of this case’s procedure may have impacted the failure of the surgery?
Expert Witness Response E-010762
I have performed multiple mitral valve repair and replacement operations. Generally, intraoperative trans-esophageal echocardiography is the standard of care after repair or replacement of the mitral valve. This allows the surgeon the check the adequacy of the repair or replacement and perform corrections to the procedure while still in the operating room if problems are identified.
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