By Choi-Keung Ng
Preoperative and intraoperative echocardiography has turn into an vital software for steering mitral valve surgical procedure and has fostered the advance of many leading edge surgical strategies. Mitral valvuloplasty is now a longtime surgical approach for the remedy of mitral insufficiency however the luck is essentially depending on the level of the underlying affliction of the mitral valve. The publication by means of Dr. Ng and coauthors is a unprecedented presentation of the relation among echocardiographic reveal of mitral valve pathology and reconstructive mitral valve surgical procedure. The atlas presents a superb illustrative advisor to educate echocardiographic-anatomic correlations and educates the reader at the innovations of mitral valve fix. the standard of the illustrations, fairly the surgical photos is beautiful. The publication could be useful for cardiologists and cardiac surgeons.
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Extra info for Modern Mitral Valve Repair: Echocardiographic Interpretations and Surgical Strategies
2. Perforation and rupture as a complication after endocarditis FIG. 3. The arrow on the 4-chamberTEE view indicates the dissection of the anterior leaflet FIG. 4. 6 FIGs. 6. Photographs demonstrates dissection at the coapting edge of the anterior leaflet and multiple perforations Mitral valve surgery for complications of endocarditis 31 the pericardium, or from the aortic root and adjacent septum into the right ventricle, the pulmonary artery, or the right atrium. These complications are well depicted by TEE imaging.
5. A mitral valve repair always requires generous resection of the prolapsed leaflet to avoid systolic anterior motion (SAM) of the mitral valve FIG. 6. Posterior leaflet reconstruction with leaflet-toannulus approximation after leaflet sliding plasty FIG. 7. The length ratio of the anterior leaflet to the posterior leaflet (3 : I) needs to be considered in order to avoid development of SAM FIG. S. After annulopasty ring implantation and proper estimation of (3: I) length ratio, SAM will not occur 25 Leaflet sliding plasty , T~cltniqu~ 0/ulljln lidilfg Platy FIG.
5 and 6 shows an example of leaflet sliding plasty for the treatment of a combined mitral defect with prolapse of the anterior leaflet and an infectious posterior leaflet. Using the combined technique in this case, not only is the prolapse corrected, but the infection is also successfully treated . FIG. 5. Combination of leaflet sliding plasty to the posterior leaflet and chordal shortening at the anterior leaflet for the treatment of a complex valve pathology 10 MITRAL VALVE SURGERY IN THE PRESENCE OF FLAIL LEAFLET Ruptured chordae tendineae may involve chordae inserting into either leaflet.