Atlas of Mitral Valve Repair by Edward B. Savage MD, Steven F. Bolling MD

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By Edward B. Savage MD, Steven F. Bolling MD

This full-color atlas with accompanying video DVD presents a whole and sensible "how-to" consultant to making plans and appearing mitral valve fix surgical procedure for mitral regurgitation. The e-book stories the traditional background of mitral regurgitation, the practical anatomy of the mitral valve, and using echocardiography in preoperative review and surgical making plans. Chapters describe and illustrate all thoughts at present used for mitral valve fix and speak about results.

A bound-in DVD provides narrated videos of six circumstances that convey the applying of particular options. every one case starts off with preoperative echocardiograms demonstrating the mitral valve disorder and proceeds via key surgical maneuvers.

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Example text

15 Posterior folding plasty. (From Spencer FC, Galloway AC, Grossi EA, et al. Recent developments and evolving techniques of mitral valve reconstruction. Ann Thorac Surg. ) POSTERIOR FOLDING PLASTY Another approach for a large redundant posterior leaflet is the posterior folding plasty described by Spencer et al. (7) (Figs. 16). Raman et al. described a variant of this procedure, which they called the double-breasted repair, and reported its application in 36 patients (8). In comparing this with standard quadrangular resection using annular plication they noted lower transmitral gradients (Fig.

E: The ring is secured in place. 11 Mobilization of the posterior leaflet. 12 Reattachment of posterior leaflet creating a Case 1) posterior sliding plasty. (Clip 5, Case 1) Gillinov et al. 5 centimeters (5) (Figs. 12). A variant of this technique is described by Gillinov and Cosgrove for asymmetric leaflets in which one side is taller than the other because the quadrangular resection leaves leaflets of varying heights (6) (Figs. 14). 13 Modified sliding leaflet repair. (From Gillinov AM, Cosgrove DM.

6), reapproximating the cut edges of the leaflet taking care not to bunch up and foreshorten the leaflet. A second suture at the annulus pulls together the two cut edges at the annular level and the first suture is tied to this second, completing the leaflet reapproximation. This is then run to the apex of the annular fold and tied to a third anchoring suture. Completion of this repair may pull open a previously occlusive cleft between scallops, requiring simple closure with a figure-of-eight suture.

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