Mitral leaflet anatomy revisited

Slides:

Advertisements

Similar presentations

Tubular heart valves: A new tissue prosthesis design—Preclinical evaluation of the 3F aortic bioprosthesis James L. Cox, MD, Niv Ad, MD, Keith Myers, BS,

Advertisements

Max B. Mitchell, MD The Journal of Thoracic and Cardiovascular Surgery

Of mice and men and surgical transcatheter aortic valve insertion

Manuel J. Antunes, MD, PhD, DSc

A cherry blossom moment in the history of heart valve replacement

Aortic valve replacement in low-flow, low-gradient aortic stenosis: Left ventricular ejection fraction matters Victor Dayan, MD, PhD, Philippe Pibarot,

Is individualized mitral valve repair in the future?

Lindsay S. Rogers, MD, Amy L. Peterson, MD, J

Visualization of vortex flow and shear stress in the aortic root during left ventricular assist device support Shohei Yoshida, MD, Satsuki Fukushima,

Aborted episode of sudden death due to delayed heart block after transcatheter aortic valve insertion Kevin L. Greason, MD, Paul A. Friedman, MD, Daniel.

Expanding options to manage traumatic thoracic vascular injuries

Bigger valve size is not always better

Quadricuspid mitral valve: Of clefts, scallops, and indentations

Building a bioartificial heart: A 3-song saga

Amine Mazine, MD, MSc, Subodh Verma, MD, PhD, Bobby Yanagawa, MD, PhD

Pulmonary hypertension in valve disease: A beast of the past?

Intrinsic cardiac stem cells are essential for regeneration

Form ever follows function

William M. DeCampli, MD, PhD

Functional mitral stenosis after mitral valve repair is a true anatomic problem that originates from the time of surgery Vincent Chan, MD, MPH, Thierry.

Mitral and tricuspid valve repair 21 years after cardiac transplantation Joss Fernandez, MD, Djurabek Babadjanov, MD, Robert Saeid Farivar, MD, PhD The.

A stitch too far: The circumflex artery in jeopardy during mitral valve repair Jeswant Dillon, MD, FRCS The Journal of Thoracic and Cardiovascular Surgery

Syed T. Hussain, MD, Kwabena Mawulawde, MD, Samir R

Bicuspid aortic valve aortopathy: One size fits all?

Coronary transfer during arterial switch—the heart of the matter?

The lord of the rings Antonio Miceli, MD, PhD

Is individualized mitral valve repair in the future?

Direct visualization of the aortic cusp from the left ventricle during aortic root reimplantation Yutaka Okita, PhD, MD, Takanori Oka, MD, Shunsuke Miyahara,

The variability of the mitral valve anatomy and terminology

Quality of mitral valve surgery at the United States Department of Veterans Affairs Juan A. Crestanello, MD The Journal of Thoracic and Cardiovascular.

Vladimiro L. Vida, MD, PhD, Fabio Zucchetta, MD, Giovanni Stellin, MD

Tricuspid annular plane systolic excursion: The welcome parameter

Innovation and science: The future of valve design

Michele Gallo, MD, Gino Gerosa, MD

Transcatheter aortic valve replacement and surgical aortic valve replacement: Both excellent therapies J. James Edelman, MBBS(Hons), PhD, Vinod H. Thourani,

Anna Marciniak, PhD, Georgios T

Torsten Doenst, MD, PhD, Markus Richter, MD

Surgery for aortic and mitral valve disease in the United States: A trend of change in surgical practice between 1998 and 2005 Scott D. Barnett, PhD,

Kevin Bridge, MD, MSPH, Robert Saeid Farivar, MD, PhD

A cherry blossom moment in the history of heart valve replacement

Posterior leaflet mitral valve prolapse: One repair does not fit all

Fenton H. McCarthy, MD, MS, Nimesh D. Desai, MD, PhD

Replicating the success of mitral valve repair in the aortic valve

Manuel J. Antunes, MD, PhD, DSc

Surgical management of symptomatic cardiac fibromas in children

Commentary: Ongoing advancements in the understanding of tricuspid valve dynamics and functional geometry Daniel J.P. Burns, MD, MPhil The Journal of.

Passing the torch The Journal of Thoracic and Cardiovascular Surgery

Biomaterials for heart valve replacement: Conjectures and refutations

Shunt right or left? Decision 2016

Warfarin or aspirin after mitral valve repair: Why work harder?

Long-term follow-up of a patient with Uhl anomaly after biologic and mechanical circulatory support Evgenij V. Potapov, MD, PhD, Tomohiro Saito, MD,

Hans-Joachim Schäfers, MD

The origins of open heart surgery at the University of Minnesota 1951 to 1956 Richard A. DeWall, MD The Journal of Thoracic and Cardiovascular Surgery

The Journal of Thoracic and Cardiovascular Surgery

Discussion The Journal of Thoracic and Cardiovascular Surgery

Severe tricuspid or mitral regurgitation in inoperable patients with aortic stenosis. Can we leave them alone? Juan A. Crestanello, MD The Journal of.

The future of cardiac surgery training: A survival guide

Permanent pacemaker insertion following transcatheter aortic valve replacement: Not infrequent, not benign, and becoming predictable Craig M. Jarrett,

The continuing challenge of congenital heart disease in China

After neoadjuvant chemoradiation therapy, predicted pulmonary function may be reduced by 10% Benny Weksler, MD, MBA The Journal of Thoracic and Cardiovascular.

“The more things change…”: The challenges ahead

Toward a more rational approach in treating type B aortic dissection

Evaluating the best approach to treatment of aortic stenosis: The jury is still out Glen B. Taksler, PhD The Journal of Thoracic and Cardiovascular Surgery

Francesco Nappi, MD, Cristiano Spadaccio, MD, PhD

Preoperative PFTs: The answer is blowing in the wind

The arithmetic of a successful mitral valve repair

Chordal replacement with polytetrafluoroethylene sutures for mitral valve repair: A 25- year experience Tirone E. David, MD, Susan Armstrong, MSc, Joan.

Surgical techniques for posterior aortic root enlargement

Designing valves: An art or science?

Marc Gillinov, MD, Per Wierup, MD, PhD, Stephanie Mick, MD

Presentation transcript:

Mitral leaflet anatomy revisited Jason L. Quill, BS, Alexander J. Hill, PhD, Timothy G. Laske, PhD, Ottavio Alfieri, MD, Paul A. Iaizzo, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 137, Issue 5, Pages 1077-1081 (May 2009) DOI: 10.1016/j.jtcvs.2008.10.008 Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 The relative orientation of the human mitral valve (MV) with respect to the other cardiac valves is shown on the left. This is a view of the base of the heart looking toward the apex, with the atria and great vessels removed. The anterior (A) and posterior (P) leaflets of the mitral valve were labeled along with the aortic valve (AV), the pulmonary valve (PV), and the tricuspid valve (TV). The alpha-numeric diagram on the right shows Carpentier's description1,2 of the mitral valve leaflets. Kumar et al's description6 differs only by the addition of the starred regions and nomenclature. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1077-1081DOI: (10.1016/j.jtcvs.2008.10.008) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Of the 38 human hearts studied, cleft locations were compared with Carpentier's description as shown by the diagram and labeled regions. Clefts that occurred within a scallop region instead of the diagrammed commissure positions were tallied in the scallop region they were discovered and termed “deviant” clefts. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1077-1081DOI: (10.1016/j.jtcvs.2008.10.008) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Shown is a histogram of anterior and posterior scallop frequencies, which indicates that the average number of anterior leaflet scallops is 1.19 ± 0.40 and the number of posterior leaflet scallops is 2.97 ± 1.03. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1077-1081DOI: (10.1016/j.jtcvs.2008.10.008) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Two mitral valves are shown in systolic (A, C) and diastolic (B, D) positions with the anterior leaflet to the left and the posterior leaflet to the right. Blue arrows signify deviant clefts, and red arrows signify standard clefts. The mitral valve in panels A and B contains 3 deviant clefts in regions P1, P2, and A3, with 2 standard clefts. The mitral valve in panels C and D has 4 deviant clefts in the A1, P1, P2, and P3 regions. This mitral valve has 1 standard cleft between P2 and P3 but is lacking a standard cleft between P1 and P2. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1077-1081DOI: (10.1016/j.jtcvs.2008.10.008) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions