Leaflet repair and valve sparing (inclusion technique) aortic root repair: reference to the latest principles
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Up to 150 words summarising the case presentation and outcome (this will be freely available online). A Marfan case with dilated aortic root and prolapsed leaflets underwent aortic repair. The non-coronary leaflet-measured effective height was 7 mm (prolapsing) and was lifted up to 10 mm with a centrally placed plicating sutures. The right coronary leaflet had a geometric height of 17 mm (restricted) and was enlarged up to 21 mm with an autologous pericardial patch. The enlarged root was repaired with an inclusion technique. The final result showed a competent valve. This report outlines the feasibility of aortic repair provided one adheres to the principles of aortic valve repair.Keywords:
Aortic valve repair
Leaflet (botany)
Aortic Valve Insufficiency
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Leaflet (botany)
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Posterior mitral valve leaflet repair is safe, effective and durable and can be performed through conventional sternotomy or by using minimally invasive thoracoscopic or robotic-assisted approaches.Triangular resection with ventricularization, quadrangular resection with sliding or folding leaflet reconstruction, neochordae implantation and edge-to-edge leaflet repair are different techniques for eliminating the prolapsing mitral leaflet segment and restoring normal leaflet coaptation.Recent studies have demonstrated that minimally invasive approaches are associated with a reduced risk of postoperative complications, shorter hospital stay and improved cosmetic outcomes when compared to conventional sternotomy.In this review, we sought to describe technical aspects of robotic posterior mitral valve repair.
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We describe a case of osteogenesis imperfecta in a 52-year-old man who underwent successful repair of aortic root dilatation and aortic valve insufficiency, using a bioprosthetic aortic valve anastomosed to an interposition graft.
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Aortic valve repair
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Leaflet (botany)
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Mitral valve annuloplasty
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Leaflet (botany)
Aortic valve repair
Aortic Valve Insufficiency
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Cardiac cycle
Aortic valve repair
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Aortic Valve Insufficiency
Bentall procedure
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Aortic Valve Insufficiency
Aortic valve repair
Leaflet (botany)
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Bicuspid valve
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We have previously shown in experimental settings that a leaflet foldoplasty device reduces redundant leaflet area to re-establish mitral valve (MV) coaptation. The current study investigates the in vivo device retention and functional durability following foldoplasty.The prototype is of superelastic nitinol formed into a 3-dimensional shape. It is unfolded to engage a specified area of leaflet tissue and then folded to exclude this tissue from the coaptation surface. Design modifications were made and tested in benchtop studies to determine the optimal design for durable retention within the leaflet. To evaluate in vivo performance, posterior leaflet chordae were severed in Yorkshire pigs to produce complete posterior leaflet prolapse and severe mitral regurgitation. Design modifications were then used for MV repair. Five animals that underwent repair using the optimal design were observed for 2 weeks postoperative to evaluate the functional result and implant retention.Device position and orientation were maintained at 2 weeks while preserving the functional MV repair in all 5 animals. Coaptation height was 5.5 ± 1.5 mm, which was not significantly different from a baseline of 4.9 ± 0.8 mm. The degree of leaflet excursion was 41.0 ± 16.0 compared to a baseline of 58.7 ± 27.5.Device foldoplasty is a new concept for MV repair based on the reduction of redundant leaflet tissue area. This study demonstrates the feasibility of safe maintenance of this repair without early dislodgement or embolization.
Leaflet (botany)
Functional mitral regurgitation
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