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Stuart A. Abel, MD, Thomas A. Stark, MD, Kent H

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1 Modified Cabrol Shunt for Atrioventricular Groove Rupture After Mitral Valve Replacement 
Stuart A. Abel, MD, Thomas A. Stark, MD, Kent H. Rehfeldt, MD, Charanjit S. Rihal, MD, Sameh M. Said, MD  The Annals of Thoracic Surgery  Volume 105, Issue 1, Pages e11-e13 (January 2018) DOI: /j.athoracsur Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 (A) Preoperative three-dimensional transesophageal echocardiographic image of the mitral valve viewed from the left atrial perspective in diastole. Both the annulus and anterior (Ant) and posterior (Post) leaflets are heavily calcified. (B) Modified bicaval transesophageal echocardiographic image after mitral valve replacement and atrioventricular groove repair. Pericardial patch material (arrowheads) is seen at the inferior aspect of the left atrium (LA). Flow can be visualized in the Hemashield graft (arrows) as it passes through an area of hematoma before entering the right atrium (RA). The Annals of Thoracic Surgery  , e11-e13DOI: ( /j.athoracsur ) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 (A) Mitral annulus. (B) Mitral annulus reinforced with bovine pericardium. (C) Pledgeted sutures around the circumference of the mitral annulus. (D) Replacement mitral valve sewn in place. The Annals of Thoracic Surgery  , e11-e13DOI: ( /j.athoracsur ) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 (A) An 8-mm Hemashield Cabrol-like shunt from the pericardial space to the right atrium. (B) Sutures placed to create a baffle between the diaphragmatic pericardium and the epicardium. (C) Baffle between the diaphragmatic pericardium and the epicardium. The Annals of Thoracic Surgery  , e11-e13DOI: ( /j.athoracsur ) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

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