Secondary Repair of Incompetent Pulmonary Valves

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Secondary Repair of Incompetent Pulmonary Valves Nestoras Papadopoulos, MD, Anoosh Esmaeili, MD, Andreas Zierer, MD, Farhad Bakhtiary, MD, PhD, Feyzan Özaslan, MD, Anton Moritz, MD, PhD The Annals of Thoracic Surgery Volume 87, Issue 6, Pages 1879-1884 (June 2009) DOI: 10.1016/j.athoracsur.2009.02.068 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Reanastomosed rupture and plication of the elongated free margin of the remaining pulmonary valve leaflets. The Annals of Thoracic Surgery 2009 87, 1879-1884DOI: (10.1016/j.athoracsur.2009.02.068) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 The dilated pulmonary root has been stabilized by resuspension within a tubular Dacron prosthesis (DuPont, Wilmington, DE), analogous to the David procedure. The Annals of Thoracic Surgery 2009 87, 1879-1884DOI: (10.1016/j.athoracsur.2009.02.068) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 A monocusp valve was shaped from glutaraldehyde-fixed autologous pericardium sewn to a strip of polytetrafluoroethylene patch. The Annals of Thoracic Surgery 2009 87, 1879-1884DOI: (10.1016/j.athoracsur.2009.02.068) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Pulmonary insufficiency grade is shown at the latest follow-up before and after secondary repair of the pulmonary valve. (PI = pulmonary insufficiency grade.) The Annals of Thoracic Surgery 2009 87, 1879-1884DOI: (10.1016/j.athoracsur.2009.02.068) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Right ventricular dilatation index (RVDI) is shown at last follow-up before and after the redo procedure. The Annals of Thoracic Surgery 2009 87, 1879-1884DOI: (10.1016/j.athoracsur.2009.02.068) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 A considerable amount of remaining pulmonary leaflet tissue was observed intraoperatively in redo operations. The Annals of Thoracic Surgery 2009 87, 1879-1884DOI: (10.1016/j.athoracsur.2009.02.068) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions