Volume 15, Issue 1, Pages (January 2012)

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Presentation transcript:

Volume 15, Issue 1, Pages 75-79 (January 2012) Mitral Regurgitation in Congenital Heart Defects: Surgical Techniques for Reconstruction Richard G. Ohye Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual Volume 15, Issue 1, Pages 75-79 (January 2012) DOI: 10.1053/j.pcsu.2012.01.012 Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 1 MV cleft closure. Illustration also shows the addition of a partial annuloplasty to improve leaflet coaptation. (Reprinted with permission from Pediatric Cardiac Surgery, Mavroudis C, Backer CL. 2003. p. 594, with permission from Mosby.) Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2012 15, 75-79DOI: (10.1053/j.pcsu.2012.01.012) Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 2 “Wooler”-type partial annuloplasty. (Reprinted with permission from Pediatric Cardiac Surgery, Mavroudis C, Backer CL. 2003. p. 591, with permission from Mosby.) Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2012 15, 75-79DOI: (10.1053/j.pcsu.2012.01.012) Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 3 “Paneth”-type partial annuloplasty. (Modified and reprinted with permission from Delmo Walter EM, Siniawski H, Ovroutski S, Hetzer R. Mitral valve growth after posterior annular stabilization with untreated autologous pericardial strip in children with mitral valve insufficiency. Ann Thorac Surg 2010;90:1580.) Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2012 15, 75-79DOI: (10.1053/j.pcsu.2012.01.012) Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 4 Various options for supported partial annuloplasties. (Modified and reprinted with permission from Oppido G, et al. Surgical treatment of congenital mitral valve disease: Midterm results of a repair-oriented policy. J Thorac Cardiovasc Surg 2008;135:1315) Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2012 15, 75-79DOI: (10.1053/j.pcsu.2012.01.012) Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 5 (A) Chordal shortening. (B) Papillary muscle shortening. (Modified and reprinted with permission from Oppido G, et al. Surgical treatment of congenital mitral valve disease: Midterm results of a repair-oriented policy. J Thorac Cardiovasc Surg 2008;135:1315.) Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2012 15, 75-79DOI: (10.1053/j.pcsu.2012.01.012) Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 6 Two techniques for creation of artificial chordae. (Modified and reprinted with permission from Pediatric Cardiac Surgery, Mavourdis C, Backer CL. 2003. Figure 32-14, p. 593, with permission from Mosby and from Oppido G, et al. Surgical treatment of congenital mitral valve disease: Midterm results of a repair-oriented policy. J Thorac Cardiovasc Surg 2008;135:1315 [Figure 2].) Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2012 15, 75-79DOI: (10.1053/j.pcsu.2012.01.012) Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 7 Quadrangular resection. A, Area of resection. B, Resection of prolapsing segment of leaflet. C, Closure of the resulting defect. Associated annuloplasty has been accomplished. D, Completed repair with partial annuloplasty ring in place. (Reprinted with permission from Pediatric Cardiac Surgery, Mavroudis C, Backer CL. 2003. Figure 32-12, p. 591, with permission from Mosby.) Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2012 15, 75-79DOI: (10.1053/j.pcsu.2012.01.012) Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 8 Leaflet augmentation. 1, Leaflet is divided at the annulus. 2, Papillary muscles and cordae are mobilize. 3, Leaflet is augmented with autologous pericardium. (Modified from Oppido G, et al. Surgical treatment of congenital mitral valve disease: Midterm results of a repair-oriented policy. J Thorac Cardiovasc Surg 2008;135:1315 [Figures 3].) Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2012 15, 75-79DOI: (10.1053/j.pcsu.2012.01.012) Copyright © 2012 Elsevier Inc. Terms and Conditions