Free Edge Suture Plication and Remodeling: A Technique for Anterior Mitral Leaflet Prolapse Repair Pino Fundarò, MD, Daniel G Di Mattia, MD, Maurizio.

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Presentation transcript:

Free Edge Suture Plication and Remodeling: A Technique for Anterior Mitral Leaflet Prolapse Repair Pino Fundarò, MD, Daniel G Di Mattia, MD, Maurizio Salati, MD, Carmine Santoli, MD The Annals of Thoracic Surgery Volume 63, Issue 4, Pages 1186-1188 (April 1997) DOI: 10.1016/S0003-4975(96)01280-5

Fig. 1 Pathologic features of myxomatous valve: prolapse by chordal elongation (A) and interchordal prolapse (B). The Annals of Thoracic Surgery 1997 63, 1186-1188DOI: (10.1016/S0003-4975(96)01280-5)

Fig. 2 Suture plication and remodeling of the free edge of the anterior leaflet. (See Fig. 1 for labels.) The Annals of Thoracic Surgery 1997 63, 1186-1188DOI: (10.1016/S0003-4975(96)01280-5)

Fig. 3 Technical detail: The correct suture must involve only the rough zone and the chordal junction (continuous thread). The body of the leaflet (clear zone) must be spared by the suture (the dotted thread shows an incorrect suture). (AL = anterior leaflet; LP = posterior leaflet; TC = chorda tendinea.) The Annals of Thoracic Surgery 1997 63, 1186-1188DOI: (10.1016/S0003-4975(96)01280-5)

Fig. 4 Operative view of suture plication and remodeling of the free edge of the anterior leaflet. The Annals of Thoracic Surgery 1997 63, 1186-1188DOI: (10.1016/S0003-4975(96)01280-5)

Fig. 5 Transesophageal echocardiograms show morphologic changes after surgical correction. (A) Before repair there is a marked anterior leaflet (AL) prolapse. A minor prolapse of the posterior leaflet (PL) is also observed. (B) After free edge remodeling, mobility of the AL is normalized. The coaptation point occurs under the annular plane. The Annals of Thoracic Surgery 1997 63, 1186-1188DOI: (10.1016/S0003-4975(96)01280-5)