title: The Alfieri stitch: the advantages for mitral valve repair in difficult circumstances.
abstract: In certain complex cases, where there is severe calcification of the mitral annulus but significant mitral regurgitation or systolic anterior motion (SAM), or in high-risk cases where prolonged bypass is to be avoided, the Alfieri-stitch repair of the mitral valve may be the most appropriate option available, particularly as it can be performed quickly through the aortic valve. We describe three cases undergoing aortic valve replacement, in which this technique was successfully applied in patients in whom more conventional repair techniques or valve replacement would have been hazardous, due to annular calcification and patient frailty.
authors: Department of Cardiac Surgery, Trent Cardiac Centre, Nottingham City Hospital, Nottingham, United Kingdom.
authors: Katrina E
authors: KE
authors: Sherlock
authors: Ganapathy
authors: G
authors: Muthuswamy
authors: Rahul
authors: R
authors: Basu
authors: Ian M
authors: IM
authors: Mitchell
mesh_terms: D000368:Aged; D004452:Echocardiography; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013902:Radiography, Thoracic; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures