scholarly journals Aortic Valve Leaflet Perforation after Mitral Valve Repair

2013 ◽  
Vol 114 (3) ◽  
pp. 172-176 ◽  
Author(s):  
M. Aboelnasr ◽  
Vilém Rohn
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Mitral Valve Repair ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Valve Repair ◽  
Mitral Repair ◽  
Autologous Pericardial Patch ◽  
Aortic Leaflet ◽  
Coronary Cusp

 A 32-year-old patient with symptomatic severe aortic regurge, 6 weeks after mitral valve repair, was admitted for aortic valve surgery. No preoperative clinical data consistent with infective endocarditis could be detected. Preoperative transthoracic echocardiography showed aortic leaflet perforation affecting non coronary cusp. During operation, leaflet perforation was detected and closed completely with autologous pericardial patch. No vegetations or abscess could be seen during operation. Iatrogenic aetiology of leaflet perforation after mitral repair was suspected in  this case. Recognition of this complication will help in  avoiding it during mitral valve surgery and expecting it as a possible complication during intraoperative transesophageal echocardiography.

scholarly journals Microinvasive Mitral Valve Surgery: A New Frontier to Tackle Mitral Regurgitation

2021 ◽  
Author(s):  
Solomon Seifu ◽  
Eduardo de Marchena
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Repair System ◽  
Valve Repair ◽  
Mitral Repair ◽  
New Frontier ◽  
Clinical Benefits

Microinvasive, catheter-based mitral valve repair of severe mitral regurgitation utilizes less invasive approaches with less procedural morbidity and mortality. The procedural steps and clinical benefits of the transcatheter transapical mitral valve annuloplasty (AMEND mitral repair implant) and transcatheter transapical chordal repair systems (Neochord DS 1000 device and Harpoon Mitral Valve Repair System) are reviewed in this manuscript.

Mitral Valve Repair Versus Replacement in Simultaneous Mitral and Aortic Valve Surgery for Rheumatic Disease

2007 ◽  
Vol 83 (2) ◽  
pp. 558-563 ◽  
Author(s):  
Kenji Kuwaki ◽  
Nobuyoshi Kawaharada ◽  
Kiyofumi Morishita ◽  
Tetsuya Koyanagi ◽  
Hisayoshi Osawa ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Rheumatic Disease ◽  
Mitral Valve Repair ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Valve Repair

Redo mitral valve surgery following prior mitral valve repair

2018 ◽  
Author(s):  
Arman Kilic ◽  
Mark R. Helmers ◽  
Jason J. Han ◽  
Rahul Kanade ◽  
Michael A. Acker ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Valve Repair

scholarly journals Can We Predict Failure of Mitral Valve Repair?

2019 ◽  
Vol 8 (4) ◽  
pp. 526 ◽  
Author(s):  
Simone Gasser ◽  
Maria von Stumm ◽  
Christoph Sinning ◽  
Ulrich Schaefer ◽  
Hermann Reichenspurner ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Mitral Valve Repair ◽  
Mitral Valve Surgery ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Left Ventricular Ejection ◽  
Redo Surgery ◽  
Valve Repair

Objective: To identify echocardiographic and surgical risk factors for failure after mitral valve repair. Methods: We identified a total of 77 consecutive patients from our institutional mitral valve surgery database who required redo mitral valve surgery due to recurrence of mitral regurgitation after primary mitral valve repair. A control group of 138 patients who had a stable echocardiographic long-term result was included based on propensity score matching. Systematic analysis of echocardiographic parameters was performed before primary surgery; after mitral valve repair and prior to redo surgery. Risk factor analysis was performed using multivariate Cox regression model. Results: Redo surgery was associated with the presence of pulmonary hypertension ≥ 50 mmHg (p = 0.02), a mean transmitral gradient > 5 mmHg (p = 0.001), left ventricular ejection fraction ≤ 45% (p = 0.05) before surgery and mitral regurgitation ≥moderate at time of discharge (p = 0.002) in the whole cohort. Patients with functional mitral valve regurgitation had a higher tendency to undergo redo surgery if preoperative left ventricular end-diastolic diameter exceeded 65 mm (p = 0.043) and if postoperative tenting height exceeded 6 mm (p = 0.018). Low ejection fraction was not significantly associated with the need for redo mitral valve surgery in the functional subgroup. Conclusions: Recurrent mitral regurgitation is still a valuable problem and is associated with relevant perioperative mortality. Patients with severe mitral regurgitation should undergo early mitral valve repair surgery as long as systolic pulmonary artery pressure is low, left ventricular ejection fraction is preserved, and LVEED is deceeds 65 mm.

Left Atrial Roof: An Alternative Minimal Approach for Mitral Valve Surgery

2012 ◽  
Vol 7 (6) ◽  
pp. 417-420 ◽  
Author(s):  
Giampiero Esposito ◽  
Giangiuseppe Cappabianca ◽  
Samuele Bichi ◽  
Davide Patrini ◽  
Pasquale Pellegrino
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Left Atrial ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Mitral Repair ◽  
Venous Cannula ◽  
Surgical Incisions ◽  
Effective Option

Objective The most common surgical incisions to expose the mitral valve include a paraseptal left atriotomy or a transeptal biatrial approach. Both techniques are normally performed through a full sternotomy and bicaval cannulation. We report our experience with an alternative incision to expose the mitral valve using the left atrial roof (LAR) through a complete sternotomy or a J-shaped upper ministernotomy. Methods Between 2007 and 2011, a total of 512 patients underwent mitral procedures using the LAR approach. A J-shaped ministernotomy was performed in 189 patients, and 61 of these had concomitant aortic valve/root procedures. A standard sternotomy was performed in 323 patients, and 126 of these had concomitant aortic valve/root procedures. The repair rate in patients with mitral regurgitation was 398 of 460 (86.5%). Results In-hospital mortality was 2.3%. An adjunctive pericardial patch to repair the LAR was necessary in 1.9% of patients. A permanent pacemaker was necessary in 3.1% of patients. Four-year survival rate was 91% ± 4.2%. In patients who underwent mitral repair, 4-year freedom from mitral regurgitation greater than 2 was 97.4%. Conclusions The LAR approach is a safe and effective option to perform mitral valve surgery. The limited extension of this incision and the possibility to use a single venous cannula make this approach suitable for minimally invasive isolated mitral valve procedures, whereas the proximity of the LAR to the aortic root makes this approach particularly attractive for combined mitroaortic procedures through a ministernotomy.

The Use of the Mini-Cardiopulmonary Bypass Circuit in Robotic Mitral Valve Surgery

2008 ◽  
Vol 3 (1) ◽  
pp. 16-18 ◽  
Author(s):  
Robert W. Emery ◽  
Goya V. Raikar ◽  
Barbara Murphy ◽  
Anton Rohan ◽  
Kris Nielsen
Keyword(s):  
Cardiopulmonary Bypass ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
High Efficiency ◽  
Mitral Valve Surgery ◽  
Circulatory Support ◽  
Valve Repair ◽  
Mitral Repair ◽  
Perfusion Time ◽  
Mitral Surgery

Background Computer enabled robotic mitral valve repair cases have longer cross-clamp and perfusion times because of the more technically difficult procedure. To modify some of the well-documented side effects of standard cardiopulmonary bypass (CPB), we used a new mini-circuit on three robotic mitral cases. Methods Three patients having mitral valve repair (triangular resection of P2 and annuloplasty ring) using the daVinci Robot (Intuitive Surgical, Sunnyvale, CA) had circulatory support using a modified Resting Heart System (Medtronic, Inc., Fridley, MN), a vertically oriented space saving CPB configuration incorporating a high efficiency miniaturized oxygenator, centrifugal pump, shortened heparin coated tubing and an air evacuation system with a closed circuit. Results All patients had successful mitral repair (echo = 0 to trace residual leakage) under a cross-clamp time of 161 ± 54 minutes and perfusion time of 229 ± 31 minutes. No blood was given during CPB and 0.7 ± 1.2 red cell units after the CPB run and 0.7 ± 1.2 units during the postoperative course. Conclusion Miniaturized bypass circuit reducing the level of necessary anticoagulation, hemodilation, and blood trauma can be used despite the increased perfusion time necessary for robotic mitral surgery.

scholarly journals Right Minithoraсotomy as a Standard Approach for Mitral Valve Surgery

2020 ◽  
pp. 23-28
Author(s):  
O. D. Babliak ◽  
V. M. Demianenko ◽  
D. Y. Babliak ◽  
A. I. Marchenko ◽  
K. A. Revenko ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Mitral Valve Repair ◽  
Tricuspid Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Standard Approach ◽  
Wound Complications ◽  
Tricuspid Valve Repair ◽  
Valve Repair

  Background. Minimally invasive mitral valve surgery provides many advantages for patients. The aim. To investigate and represent our own experience in minimally invasive mitral valve surgery, and to describe the operative technique. Materials and methods. The study was included 100 consecutive patients who underwent a minimally invasive mitral valve repair or replacement through the right lateral minithoracotomy from June 2017 to December 2019. Results. Mitral valve repair was performed in 87 patients (87%), and 13 patients (13%) were required mitral valve replacement. In 24 patients (24%), concomitant procedures were performed: tricuspid valve repair, atrial septal defect repair and left atrial myxomectomy. Ring anuloplasty was performed in all patients who underwent mitral valve repair. Additional methods of correction were used in accordance to the lesion anatomy: neochords implantation, cleft and leaflet perforation closure, leaflet resection, Alfieri (edge-to-edge) stitch, posterior leaflet plication. There was no in-hospital and 30-day mortality. Post-operative strokes were not reported. No wound complications were observed in the femoral cannulation area. The total length of stay in a hospital was 6 ± 1.46 (3–9) days. There were no cases of mitral valve insufficiency greater more than mild degree after mitral valve repair at the time of discharge. Conclusions. Minimally invasive mitral valve surgery can be performed as a routine standard approach, provides safe and effective correction of the mitral valve defects, allows excellent results of mitral valve repair and replacement in various abnormalities. Minimally invasive approach enables to perform a large number of reconstructive valve techniques and perform simultaneous correction of atrial septal defects, tricuspid valve repair and atrial neoplasm removal.

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