Use of an inverted On-X mitral valve in the aortic position in a resource limited setting.


Implanting an inverted aortic valve prosthesis in the mitral position has shown to be a viable solution for a small mitral annulus. We describe a case of implanting an inverted in the mitral prosthesis in the aortic position in a patient with an excessively large aortic annulus. A 46-year-old male with severe aortic insufficiency underwent aortic valve replacement during a surgical outreach program in Tegucigalpa, Honduras. Aortic valve annulus measured 30 mm on preoperative echocardiogram. An inverted On-X mechanical mitral heart valve with Conform-X sewing ring 25/33 mm was implanted with an excellent hemodynamic result and no paravalvular leak. To the best of our knowledge, this case demonstrates the first inverted mitral prosthesis implanted in the aortic valve position.





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Publication Info

Jimenez Contreras, Fabian, Alejandro Murillo-Berlioz, Jatin Anand, Claire Aksamit, Hugo Orellana, Carmelo A Milano and Adam R Williams (2020). Use of an inverted On-X mitral valve in the aortic position in a resource limited setting. Journal of cardiac surgery, 35(11). pp. 3239–3241. 10.1111/jocs.14974 Retrieved from

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Carmelo Alessio Milano

Joseph W. and Dorothy W. Beard Distinguished Professor of Experimental Surgery

Adam Richard Williams

Assistant Professor of Surgery

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