By Edward B. Savage MD, Steven F. Bolling MD
This full-color atlas with accompanying video DVD presents a whole and useful "how-to" advisor to making plans and appearing mitral valve fix surgical procedure for mitral regurgitation. The booklet stories the typical background of mitral regurgitation, the useful anatomy of the mitral valve, and using echocardiography in preoperative review and surgical making plans. Chapters describe and illustrate all thoughts presently used for mitral valve fix and talk about results.
A bound-in DVD provides narrated videos of six circumstances that convey the appliance of particular concepts. every one case starts with preoperative echocardiograms demonstrating the mitral valve disorder and proceeds via key surgical maneuvers.
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Additional info for Atlas of Mitral Valve Repair
The aim is to remodel the annulus to a systolic shape. Cohn reported that the use of an annuloplasty ring was significantly associated with a reduced incidence of reoperation for repair failure (2). It is generally accepted that some sort of mechanical support is necessary to maintain the integrity of the repair, though some argue it can be used selectively (3,4). If some residual regurgitation is noted upon completion, the annuloplasty should prevent progression. Many different types of annuloplasty techniques have been described, some using plicating sutures, circumferential shortening sutures, bands to support the posterior annulus, and complete rings.
A: A quadrangular resection of the diseased scallop is performed. B: The remaining posterior leaflet is detached from the annulus. C: Sutures are passed through the posterior annulus in a parallel orientation; the free edges of the leaflets are reapproximated. D: The leaflet is sewn to the annulus with a 4-0 monofilament and the leaflets reapproximated with 5-0 monofilament. 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.
Therefore, repair of the anterior leaflet requires more imagination, often requires a combination of repair techniques, and is considered more prone to failure on long-term follow-up. However, this assumption is contraindicated by Grossi et al. who found, after reviewing 588 consecutive repairs, that the requirement for anterior leaflet repair did not increase the risk for reoperation (1). General principles of anterior leaflet repair include elimination of redundancy and excess tissue, elimination of prolapse, and maintenance of pliability.