title: Asymmetric Alfieri's stitch to correct systolic anterior motion after mitral valve repair.
abstract: Systolic anterior motion of the mitral valve is a feared complication after valve repair, with important implications in the postoperative period. Provocation with isoproterenol is valuable in the assessment of its mechanism and severity in high-risk patients. Surgical correction of this condition is sometimes difficult and may require valve replacement. We present a modification of Alfieri's edge-to-edge technique that adapts better to the mechanism of systolic anterior motion (SAM) after mitral repair in selected patients by placing the edge-to-edge suture between the A1-P1 segments and not in the midline.
authors.affiliation: Division of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pereda
authors.forename: Yan
authors.initials: Y
authors.lastname: Topilsky
authors.forename: Rick A
authors.initials: RA
authors.lastname: Nishimura
authors.forename: Soon J
authors.initials: SJ
authors.lastname: Park
mesh_terms: D017548:Echocardiography, Transesophageal; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation / Q000379:methods; D013536:Suture Techniques; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery