1. Neonatal Mitral and Tricuspid Valve Repair for In Utero Papillary Muscle Rupture 
Petros V. Anagnostopoulos, MD, Nelson Alphonso, MD, Lars Nölke, MD, Lisa K. Hornberger, MD, Gary W. Raff, MD, Anthony Azakie, MD, Tom R. Karl, MD 
The Annals of Thoracic Surgery 
Volume 83, Issue 4, Pages (April 2007)
DOI: /j.athoracsur
Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

2. Fig 1
Valve insufficiency secondary to a ruptured papillary muscle (arrow).
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

3. Fig 2
The leaflet free edge is supported with neochordae of 6-0 expanded polytetrafluoroethylene, sutured to the base of a papillary muscle, but not in the infarcted area. The length is adjusted to neutralize the prolapse.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

4. Fig 3
The tricuspid valve annulus us stabilized using a modified de Vega technique with a 5-0 expanded polytetrafluoroethylene suture. The ends of the suture are passed through the wall of the right atrium and controlled with a tourniquet. The annulus can be adjusted after separation from cardiopulmonary bypass using transesophageal control. (SVC = superior vena cava.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions