Valved-conduit-on-valve implantation for physiologic total chordal preservation in rheumatic mitral valvulopathy Jen-Ping Chang, MD, Chien-Ming Lo, MD,

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Presentation transcript:

Valved-conduit-on-valve implantation for physiologic total chordal preservation in rheumatic mitral valvulopathy Jen-Ping Chang, MD, Chien-Ming Lo, MD, Chia-Chen Wu, MD, Morgan Fu, MD The Journal of Thoracic and Cardiovascular Surgery Volume 149, Issue 5, Pages 1453-1455 (May 2015) DOI: 10.1016/j.jtcvs.2014.12.060 Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 A, Intraoperative picture showing the fenestrated anterior leaflet with preserved mitral apparatus continuity. B, A polyethylene terephthalate tube of the mitral annular size was implanted with inside-out horizontal mattress sutures. C, A mechanical valvular prosthesis of corresponding outer diameter was implanted to the polyethylene terephthalate tube with outside-in horizontal mattress sutures. D, A drawing showing the full scheme of the valved-conduit-on-valve mitral implantation technique. Several outside-in pledgetted sutures on the left atrial floor were used to bypass the severe annular calcification. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 1453-1455DOI: (10.1016/j.jtcvs.2014.12.060) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Postoperative transthoracic echocardiography with color flow mapping showing that the mitral flow went through the conduit and the fenestrated anterior leaflet (between red arrow heads) into the left ventricle fluently. B, The mitral annular motion was preserved (diastolic annular diameter, 2.75 cm; systolic annular diameter, 1.52 cm) without any evidence of left atrial thrombus. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 1453-1455DOI: (10.1016/j.jtcvs.2014.12.060) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions