Posterior leaflet division and augmentation technique for repairing rheumatic mitral valve
Mehmet Ali Sahin, Erkan Kuralay.
Abstract
Leaflet mobilization is an important part of rheumatic mitral valve disease repair. Conventional commissurotomy techniques may not allow leaflet mobilization in some patients. We described a new technique for adequate mobilization of the posterior leaflet. First, we performed mitral commissurotomy in both commissures. The posterior leaflet was then separated from the posterior annulus from the anterolateral commissure to the posteromedial commissure. Tertiary and secondary chordae were removed. The posterior leaflet was divided vertically into two parts. After removal of the fibrous attachments, the pericardial patch was sutured to the entire posterior leaflet. The artificial chordae were re-implanted in the neo-P2 region of the porterior leaflet to achieve good coaptation. We did not use a ring after the mitral valve repair was completed.
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