Modified Edge-to-Edge Technique for Correction of Congenital Mitral Regurgitation in Infants and Children Gang Zhang, MD, Fusheng Zhang, MD, Mei Zhu,

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Modified Edge-to-Edge Technique for Correction of Congenital Mitral Regurgitation in Infants and Children Gang Zhang, MD, Fusheng Zhang, MD, Mei Zhu, MD, Wenlong Zhang, MD, Quanxin Fan, MD, Chengwei Zou, MD, Anbiao Wang, MD The Annals of Thoracic Surgery Volume 92, Issue 4, Pages e89-e91 (October 2011) DOI: 10.1016/j.athoracsur.2011.05.030 Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Modified edge-to-edge technique. (A) A pledget-reinforced horizontal mattress stitch with No. 5-0 polypropylene, with the knot tied on the ventricular side. (B) Lateral view of this suture. (C) A pledget-reinforced mattress stitch with Gore-Tex suture (W.L. Gore & Associates, Flagstaff, AZ) and Dacron pledgets (Chest, Shanghai) placed on the anterior and posterior annulus corresponding to the edge-to-edge suturing site. (D) The Gore-Tex suture is passed into the mitral valve leaflets. The Annals of Thoracic Surgery 2011 92, e89-e91DOI: (10.1016/j.athoracsur.2011.05.030) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Apical four-chamber view of preoperative echocardiographic images showing prolapse of the anterior leaflet (A) and severe mitral regurgitation (B) with color Doppler echocardiography. Postoperative parasternal short-axis view showing the double-orifice mitral valve (C) and intuitive image with real-time three-dimensional echocardiography (D). Directed jet of double-orifice mitral valve (E) and transvalvular pressure gradients calculated in color Doppler echocardiography are normal (F). (LA = left atrium; LV= left ventricle; RA = right atrium; RV = right ventricle.) The Annals of Thoracic Surgery 2011 92, e89-e91DOI: (10.1016/j.athoracsur.2011.05.030) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions