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Repair of rheumatic mitral regurgitation in children.

Kumar AS - Ann Pediatr Cardiol (2011)

View Article: PubMed Central - PubMed

Affiliation: Pushpanjali Institute of Cardiac Sciences, Pushpanjali Crosslay Hospital, Ghaziabad, UP.

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Considering the disadvantages of prosthetic valve in the pediatric age-group, it is important for surgeons and cardiologists to be aware of the feasibility, techniques and outcomes of MV repair in this subgroup of patients... There are several publications on techniques of repair of MVs for various indications... However, a step-by-step “how to do text” with illustration can only be found in a few publications... The sternotomy incision is preferred in children with additional aortic valve pathology as well... For a superior cosmetic result a right thoracotomy is recommended for older children (15 kg or more)... Cardioplegia is delivered into the aortic root... The superior vena cava (SVC) and inferior vena cava (IVC) are looped... Chordal rupture is treated by i) reattachment of chordae ii) excision of ruptured chordae with a triangular resection of AML tip or Quadrangular resection of a PML scallop... The resultant defect is closed by a 5-0 suture. iii) By Chordal transfer... This step will show any free or ruptured chordae and residual areas of prolapse... An annuloplasty is necessary to remodel and reduce the dilated MV annulus... The AML can now be measured using the standard sizers used for mechanical valves... The atriotomy incision is now closed with 3-0 monofilament using two sutures which begin at either end of the incision... Tricuspid and aortic valve function.

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The technique of cuspal thinning. The fibrous peel is being removed from the anterior mital leaflet to gain length and make it more compliant
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Figure 5: The technique of cuspal thinning. The fibrous peel is being removed from the anterior mital leaflet to gain length and make it more compliant

Mentions: 2. Cuspal thinning: Rheumatic valves are usually encased in thick and often fibrotic endocardium. The purpose of this procedure is therefore to gain the width of the cusp and increase its area of coaptation with the other cusp.[5] For this the thickened endocardium at the base of the AML (12 o clock position in surgical view) is grasped with a tissue forceps [Figure 5].


Repair of rheumatic mitral regurgitation in children.

Kumar AS - Ann Pediatr Cardiol (2011)

The technique of cuspal thinning. The fibrous peel is being removed from the anterior mital leaflet to gain length and make it more compliant
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104534&req=5

Figure 5: The technique of cuspal thinning. The fibrous peel is being removed from the anterior mital leaflet to gain length and make it more compliant
Mentions: 2. Cuspal thinning: Rheumatic valves are usually encased in thick and often fibrotic endocardium. The purpose of this procedure is therefore to gain the width of the cusp and increase its area of coaptation with the other cusp.[5] For this the thickened endocardium at the base of the AML (12 o clock position in surgical view) is grasped with a tissue forceps [Figure 5].

View Article: PubMed Central - PubMed

Affiliation: Pushpanjali Institute of Cardiac Sciences, Pushpanjali Crosslay Hospital, Ghaziabad, UP.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Considering the disadvantages of prosthetic valve in the pediatric age-group, it is important for surgeons and cardiologists to be aware of the feasibility, techniques and outcomes of MV repair in this subgroup of patients... There are several publications on techniques of repair of MVs for various indications... However, a step-by-step “how to do text” with illustration can only be found in a few publications... The sternotomy incision is preferred in children with additional aortic valve pathology as well... For a superior cosmetic result a right thoracotomy is recommended for older children (15 kg or more)... Cardioplegia is delivered into the aortic root... The superior vena cava (SVC) and inferior vena cava (IVC) are looped... Chordal rupture is treated by i) reattachment of chordae ii) excision of ruptured chordae with a triangular resection of AML tip or Quadrangular resection of a PML scallop... The resultant defect is closed by a 5-0 suture. iii) By Chordal transfer... This step will show any free or ruptured chordae and residual areas of prolapse... An annuloplasty is necessary to remodel and reduce the dilated MV annulus... The AML can now be measured using the standard sizers used for mechanical valves... The atriotomy incision is now closed with 3-0 monofilament using two sutures which begin at either end of the incision... Tricuspid and aortic valve function.

No MeSH data available.


Related in: MedlinePlus