By Edward B. Savage MD, Steven F. Bolling MD
This full-color atlas with accompanying video DVD presents an entire and sensible "how-to" consultant to making plans and acting mitral valve fix surgical procedure for mitral regurgitation. The booklet reports the average heritage of mitral regurgitation, the practical anatomy of the mitral valve, and using echocardiography in preoperative evaluate and surgical making plans. Chapters describe and illustrate all strategies at present used for mitral valve fix and speak about results.
A bound-in DVD provides narrated videos of six situations that convey the applying of particular suggestions. every one case starts with preoperative echocardiograms demonstrating the mitral valve illness and proceeds via key surgical maneuvers.
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Additional info for Atlas of Mitral Valve Repair
Likewise the size of the atrium will have an impact on the relative assessment of regurgitant jets and pulmonary venous flow. The other factor that impacts greatly on the degree of regurgitation is peripheral vascular resistance; this is specifically reflected by the systolic blood pressure. At lower blood pressures, particularly after the induction of anesthesia, the degree of regurgitation may be underestimated. At higher blood pressures, particularly in patients who presents with poorly controlled hypertension, the degree of regurgitation may be overestimated.
The incision should be made in hardy tissue that will hold sutures well. The leaflets are then reapproximated with a running suture between the leaflet edges continuing to fold together the annular cut edges. The atrial portion can be reinforced with a pledgeted suture (Fig. 5). Suturing is started at the leaflet edge with a simple suture tied on the ventricular side of the valve that is brought through to the atrial side to pull the edge under (Fig. 6). 4 Posterior plication to treat a ruptured chord.
This technique moves the atrial wall into the ventricle to cover the defect and relocates the valve attachment point onto the atrial wall. The leaflets are then reattached and an annuloplasty ring is placed with the sutures close to the annular defect (Fig. 22). Debridement and Pericardial Patch Closure David et al. described a similar approach to the one described above, patching the defect with pericardium instead of using primary repair (11) (Fig. 23). He also applied this technique for annular destruction by endocarditis.