title: Repair of rheumatic mitral stenosis with bicommissural release, anterior leaflet augmentation and oversized annuloplasty.
abstract: Rheumatic mitral valve disease often manifests with leaflet fibrosis, commissural fusion and early calcific degeneration. The thickening and fibrosis of the valvular and subvalvular apparatus has made prosthetic mitral replacement the traditional surgical solution. However, favourable valve morphology in some patients may permit a durable mitral repair rather than replacement. There is growing interest in reparative techniques that durably improve the mitral orifice while preserving the subvalvular apparatus. Many of these techniques are technically challenging and require complex resections with intricate chordal adjustments, which may have limited their global acceptance. In this report, we outline a three-step technique that does not require significant resection or involve the use of neochords. This offers a potentially simplified approach to the repair of rheumatic mitral stenosis.
authors.affiliation: Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Patrick G
authors.initials: PG
authors.lastname: Chan
authors.forename: Awori J
authors.initials: AJ
authors.lastname: Hayanga
authors.forename: Vinay
authors.initials: V
authors.lastname: Badhwar
mesh_terms: D002315:Cardiopulmonary Bypass / Q000379:methods; D004452:Echocardiography / Q000379:methods; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery; D058386:Mitral Valve Annuloplasty / Q000379:methods*; D008946:Mitral Valve Stenosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications*; D016896:Treatment Outcome
keywords: Leaflet augmentation; Mitral regurgitation; Mitral stenosis; Mitral valve repair; Pericardial patch; Rheumatic valve disease