Valvuloplasty with glutaraldehyde-treated autologous pericardium in patients with complex mitral valve pathology Choi-Keung Ng, MD, Joachim Nesser, MD,

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Presentation transcript:

Valvuloplasty with glutaraldehyde-treated autologous pericardium in patients with complex mitral valve pathology Choi-Keung Ng, MD, Joachim Nesser, MD, Christian Punzengruber, MD, Otmar Pachinger, MD, Johannes Auer, MD, Herbert Franke, MD, Peter Hartl, MD The Annals of Thoracic Surgery Volume 71, Issue 1, Pages 78-85 (January 2001) DOI: 10.1016/S0003-4975(00)02327-4

Fig 1 (A) Curved bar of calcium resected from posterior leaflet. (B) After en bloc decalcification, myocardium often is exposed. (C) Reconstruction with straddling endoventricular patch annuloplasty. (D–F) Repair procedure with leaflet remnants reattached to pericardial patch. The Annals of Thoracic Surgery 2001 71, 78-85DOI: (10.1016/S0003-4975(00)02327-4)

Fig 2 (A) Severe bacterial endocarditis of posterior leaflet. (B) Completion of aggressive broad excision of infected tissue. (C) A big gap in remaining tissue preventing recoaptation. (D) Valvuloplasty with pericardial patch as substitute for posterior leaflet. The Annals of Thoracic Surgery 2001 71, 78-85DOI: (10.1016/S0003-4975(00)02327-4)

Fig 3 (A) Posterior leaflet detached from the annulus. (B) Posterior leaflet extension patch plasty providing an increase of more than 50% of the surface area. The Annals of Thoracic Surgery 2001 71, 78-85DOI: (10.1016/S0003-4975(00)02327-4)

Fig 4 (A) Perforated anterior leaflet caused by acute endocarditis. (B) Patch as substitute for anterior leaflet. The Annals of Thoracic Surgery 2001 71, 78-85DOI: (10.1016/S0003-4975(00)02327-4)

Fig 5 Papillary muscle head rupture resulting from acute myocardial ischemia. The Annals of Thoracic Surgery 2001 71, 78-85DOI: (10.1016/S0003-4975(00)02327-4)

Fig 6 Chordal replacement with autologous pericardium anchored to trabecula using 7-0 polytetrafluoroethylene sutures. The Annals of Thoracic Surgery 2001 71, 78-85DOI: (10.1016/S0003-4975(00)02327-4)

Fig 7 Event-free survival (freedom from death, thromboembolism, reoperation, myocardial infarction, endocarditis, and anticoagulation-related hemorrhage) after mitral valvuloplasty. The upper graph lines represent event-free survival at the end of follow-up (freedom from death, thromboembolism, reoperation, myocardial infarction, endocarditis, and anticoagulation-related hemorrhage) after mitral valvuloplasty. The lower graph line indicates the patients at risk. The Annals of Thoracic Surgery 2001 71, 78-85DOI: (10.1016/S0003-4975(00)02327-4)