title: Surgical techniques for the management of the 'hostile mitral annulus'.
abstract: The mitral annulus can be rendered hostile by several uncommon clinical situations such as infective endocarditis, calcification, or previous valve surgery. These can all lead to difficulties seating a prosthesis or annuloplasty ring. The posterior mitral annulus or anteriorly the intervalvar fibrous body can be affected. These situations continue to pose a formidable technical challenge to the cardiac surgeon in the operating room. We review the evidence around solutions for these problems with the intent of giving surgeons an overview of techniques to address these issues.
authors: Division of Cardiac Surgery, K. D. Ambani Hospital & Medical Research Institute, Mumbai, India. Electronic address: vidyadhar.lad@relianceada.com.
authors: Vidyadhar S
authors: VS
authors: Lad
authors: Department of Surgery, St Vincent's Hospital, University of Melbourne, Australia. Electronic address: andrewenewcomb@gmail.com.
authors: Andrew E
authors: AE
authors: Newcomb
authors: Department of Surgery, St Vincent's Hospital, University of Melbourne, Australia.
authors: Philip J
authors: PJ
authors: Davis
authors: Department of Cardiothoracic Surgery, National Heart Centre, Singapore, Singapore.
authors: Chua Yeow
authors: CY
authors: Leng
mesh_terms: D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000379:methods*
keywords: Cardiac surgery; Endocarditis; Heart valve prosthesis; Mitral annular repair; Mitral valve surgery; Redo cardiac surgery