A segmental mitral suture annuloplasty technique is consisted of double-layer sutures anchored in the fibrous trigone on the valve repair side and along the annulus to the midpoint of the posterior leaflet. This suture technique is an alternative of Paneth Burr method using only one-side of the procedure. We recommend this technique especially in cases of mitral regurgitation which can be repaired by a simple resection-suture technique for posterior leaflet, and not in cases of severe annular dilatation, rheumatic, or ischemic diseases. We have examined this technique in 40 cases over the last 8 years and the results showed no recurrence of the mitral regurgitation.
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JACC Case Rep
January 2025
Department of Cardiovascular Medicine, Richmond Heart & Vascular Associates, Richmond, Virginia, USA.
Transcatheter edge-to-edge repair (TEER) is approved for patients with symptomatic severe mitral regurgitation (MR) who are deemed inoperable or at high surgical risk with life expectancy of more than 1 year, but has also been used off-label in patients with hypertrophic obstructive cardiomyopathy (HOCM) for symptomatic relief who are not candidates for septal reduction therapy. An 83-year-old woman with decompensated heart failure was found to have HOCM with systolic anterior motion of the mitral valve and a large P2 flail segment with ruptured cords. TEER was performed resulting in mild MR and resolution of the prior left ventricular outflow tract gradient.
View Article and Find Full Text PDFGen Thorac Cardiovasc Surg Cases
January 2025
Department of Cardiovascular Surgery, Osaka General Medical Center, Osaka, 558-8558, Japan.
Background: Left atrial dissection is a rare and occasionally fatal complication of cardiac surgery and is defined as the creation of a false chamber through a tear in the mitral valve annulus extending into the left atrial wall. Some patients are asymptomatic, while others present with various symptoms, such as chest pain, dyspnea, and even cardiac arrest. Although there is no established management for left atrial dissection, surgery should be considered in patients with hemodynamic disruption.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2024
Division of Cardiac Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
A 53-year-old male individual with chronic severe mitral regurgitation presented with biventricular dysfunction, pulmonary hypertension, and atrial fibrillation. Echocardiography demonstrated a posterior leaflet prolapse with malcoaptation. Mitral valve repair and Maze procedure were performed, revealing absent chordae and direct connection from the anterolateral papillary muscle to the posterior leaflet, consistent with partial mitral arcade.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2024
Department of Cardiothoracic Surgery, Government Medical College, Kottayam, Kerala, India.
Submitral aneurysm is a challenging and uncommon cardiac disease that is uniquely related to the posterior mitral valve leaflet. Awareness and prompt identification are vital because of the strong predilection for sudden fatal complications. Techniques and timing of surgical procedures are not standardized, especially in incidentally detected cases.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
September 2024
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
Anomalous supravalvular mitral chordae tendineae that originate from the mitral leaflet(s) and attach to the interatrial septum or dome of the left atrium are a rare congenital anomaly. These supravalvular chordae are often associated with severe mitral regurgitation and surgical experience has included resection of the anomalous chord as part of the repair. We describe an unusual presentation of an incidentally discovered anomalous supravalvular chord at the time of mitral valve repair for degenerative mitral regurgitation related to a flail posterior leaflet.
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