The Rheumatic Mitral Valve and Repair Techniques in Children

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The Rheumatic Mitral Valve and Repair Techniques in Children Afksendiyos Kalangos Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual Volume 15, Issue 1, Pages 80-87 (January 2012) DOI: 10.1053/j.pcsu.2012.01.013 Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 1 (A) The split & tuck-in technique. (B) Chordal shortening at the free edge of the prolapsing anterior leaflet segment. (C) Sliding shortening plasty of the elongated chordae tendinae. (D) Secondary chrodal transfer to the free edge of the prolapsing anterior leaflet segment. (E) Use of artificial cord. (F) Dislocation of the elongated head by suture fixation into an adjacent site of the papillary muscle. (G) Resection of retracted posterior and anterior leaflet secondary cordae tendinae. (H) Shaving of the thickened posterior leaflet. (I) Anterior and posterior commissural splitting. (J) Retracted posterior leaflet height increases at P2-3 segments as described by Izumoto et al.7 (K) Enlargement of the retracted posterior leaflet. (L) Suspension of the retracted free edge of the posterior leaflet segment to the opposite anterior mitral annulus. (M) Peeling of the thickened anterior leaflet. Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2012 15, 80-87DOI: (10.1053/j.pcsu.2012.01.013) Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 1 (A) The split & tuck-in technique. (B) Chordal shortening at the free edge of the prolapsing anterior leaflet segment. (C) Sliding shortening plasty of the elongated chordae tendinae. (D) Secondary chrodal transfer to the free edge of the prolapsing anterior leaflet segment. (E) Use of artificial cord. (F) Dislocation of the elongated head by suture fixation into an adjacent site of the papillary muscle. (G) Resection of retracted posterior and anterior leaflet secondary cordae tendinae. (H) Shaving of the thickened posterior leaflet. (I) Anterior and posterior commissural splitting. (J) Retracted posterior leaflet height increases at P2-3 segments as described by Izumoto et al.7 (K) Enlargement of the retracted posterior leaflet. (L) Suspension of the retracted free edge of the posterior leaflet segment to the opposite anterior mitral annulus. (M) Peeling of the thickened anterior leaflet. Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2012 15, 80-87DOI: (10.1053/j.pcsu.2012.01.013) Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 1 (A) The split & tuck-in technique. (B) Chordal shortening at the free edge of the prolapsing anterior leaflet segment. (C) Sliding shortening plasty of the elongated chordae tendinae. (D) Secondary chrodal transfer to the free edge of the prolapsing anterior leaflet segment. (E) Use of artificial cord. (F) Dislocation of the elongated head by suture fixation into an adjacent site of the papillary muscle. (G) Resection of retracted posterior and anterior leaflet secondary cordae tendinae. (H) Shaving of the thickened posterior leaflet. (I) Anterior and posterior commissural splitting. (J) Retracted posterior leaflet height increases at P2-3 segments as described by Izumoto et al.7 (K) Enlargement of the retracted posterior leaflet. (L) Suspension of the retracted free edge of the posterior leaflet segment to the opposite anterior mitral annulus. (M) Peeling of the thickened anterior leaflet. Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2012 15, 80-87DOI: (10.1053/j.pcsu.2012.01.013) Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 2 Freedom from reoperation according to the different types of mitral valve dysfunction. Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2012 15, 80-87DOI: (10.1053/j.pcsu.2012.01.013) Copyright © 2012 Elsevier Inc. Terms and Conditions