{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:04:03Z","timestamp":1777878243378,"version":"3.51.4"},"reference-count":0,"publisher":"Global Cardiology Science and Practice","issue":"2","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["gcsp"],"abstract":"<jats:p>Introduction: LVOT obstruction after surgical bioprosthetic MVP placement is uncommon and the influence of the MVP strut width has seldom been examined.\nCase presentation: A 74-year-old female presented with palpitations, chest pain, and shortness of breath. She had MVR with 31-mm bioprosthetic valve 2 years prior. TEE confirmed LVOT secondary to a MVP strut, causing a peak gradient of 55 mmHg. The redo operation was complicated by iatrogenic Type-A aortic dissection. The patient was immediately cooled for DHCA with RCP and ascending aortic replacement was performed. MVR was then performed with a prosthesis with narrower strut width. Recovery after surgery was uneventful and post-TEE confirmed absence of LVOT obstruction (gradient of 4 mmHg).\nDiscussion: This case is of interest for two reasons. Primarily, the overall profile of the valve, including the width of the struts may play a significant role in the development of LVOT obstruction after MVR. Additionally, the patient had an ITAAD requiring prompt and thoughtful management.Conclusion: This case underscores the importance of evaluating MVP profile in relation to patient anatomy. Furthermore, intraoperative Type A aortic dissection is a rare but lethal phenomenon requiring swift decision-making and technical ability, and both are important considerations for trainees.<\/jats:p>","DOI":"10.21542\/gcsp.2026.13","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:15:12Z","timestamp":1777590912000},"source":"Crossref","is-referenced-by-count":0,"title":["Complicated third sternotomy for left ventricular outflow tract obstruction secondary to mitral valve prosthesis strut"],"prefix":"10.21542","volume":"2026","author":[{"given":"Rishab","family":"Agarwal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AlleaBelle","family":"Bradshaw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Carvajal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Lawton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"8990","published-online":{"date-parts":[[2026,4,30]]},"container-title":["Global Cardiology Science and Practice"],"original-title":[],"link":[{"URL":"https:\/\/globalcardiologyscienceandpractice.com\/index.php\/gcsp\/article\/download\/1051\/733","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/globalcardiologyscienceandpractice.com\/index.php\/gcsp\/article\/download\/1051\/733","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:15:13Z","timestamp":1777590913000},"score":1,"resource":{"primary":{"URL":"https:\/\/globalcardiologyscienceandpractice.com\/index.php\/gcsp\/article\/view\/1051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4,30]]}},"URL":"https:\/\/doi.org\/10.21542\/gcsp.2026.13","relation":{},"ISSN":["2305-7823"],"issn-type":[{"value":"2305-7823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]}}}