Mitral Valve Replacement with Bileaflet Preservation for Complex Annular Calcification

Authors

  • Onur S. Goksel
  • Kaan Inan
  • Tolga Tatar
  • Alper Ucak
  • Gokhan Arslan
  • Melih Us
  • Ahmet T. Yilmaz

DOI:

https://doi.org/10.1532/HSF98.20071164

Abstract

Extensive calcification of mitral apparatus may preclude optimal valve repair, thus requiring debridement. We performed mitral valve replacement in a 55-year-old woman with a modified bileaflet preservation technique to avoid complications related to extensive debridement. Posterior transposition of the anterior leaflet as a buttress over the posterior ventricular wall provided extra support for the weakened tissues and covered the decalcified areas, which protected against debris embolism. This technique is safe and reproducible, especially for elderly patients who have complex calcification that requires extensive debridement, enables better preservation of ventricular function, and avoids disruption of the mechanical left ventricular wall.

References

Carpentier AF, Pellerin M, Fuzellier JF, Relland JY. 1996. Extensive calicification of the mitral annulus: pathology and surgical management. J Thorac Cardiovasc Surg 111:7181-30.nCasselman FP, Gillinov AM, McDonald ML, Cosgrove III DM. 1999. Use of anterior mitral leaflet to reinforce the posterior mitral annulus after debridement of calcium. Ann Thorac Surg 68:261-2.nFukada Y, Matsui Y, Sasaki Y, Yasuda K. 2005. A case of mitral valve replacement with a collar-reinforced prosthetic valve for heavily calcified mitral annulus. Ann Thorac Cardiovasc Surg 11:260-3.nFuster RG, Rodriguez I, Estevez V, Vazquez A. 2007. Posterior transposition of anterior leaflet for complete chordal preservation. Eur J Cardiothorac Surg 31:550-551.nKuralay E, Demirkilic U, Gunay C, Tatar H. 2002. Mitral valve replacement with bileaflet preservation: a modified technique. Eur J Cardiothorac Surg 22:630-2.nLee EM, Shapiro LM, Wells FC. 1996. Importance of subvalvular preservation and early operation in mitral valve surgery. Circulation 94:2117-23.n

Published

2008-02-12

How to Cite

Goksel, O. S., Inan, K., Tatar, T., Ucak, A., Arslan, G., Us, M., & Yilmaz, A. T. (2008). Mitral Valve Replacement with Bileaflet Preservation for Complex Annular Calcification. The Heart Surgery Forum, 11(1), E1-E3. https://doi.org/10.1532/HSF98.20071164

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