Abstract
Methods We present a retrospective study on 120 cases with degenerative mitral regurgitation in which surgical mitral reconstruction has been tried in the last 5 years. 29 Barlow diseases, 50 FED, 20 idiopathic calcification of PML. Preoperative echographic and intraoperative valve analysis reveals risks factors for SAM; small LV, bulging septum, redundant leaflets, reduced mitro aortic angle, anterior coaptation line. All patients were operated with classical approach, median sternotomy, CEC, standard techniques for mitral valve reconstruction. Surgical methods for SAM prevention are; rings of corresponding dimensions, avoidance of large quadrangular resections, reconstruction of correct ratio between PML and AML dimensions by annular sliding; for large PML prefers the chordae insertion or butterfly resection.
Highlights
BackgroundSAM is a life threatening condition with up to 20% risk of sudden death. The present study analyses the mitral reconstructions performed by the authors during the last 5 years, from the point of view of preoperative risk for SAM, the appearance rate of post operative SAM and the ways of dealing with it
We present a retrospective study on 120 cases with degenerative mitral regurgitation in which surgical mitral reconstruction has been tried in the last 5 years
Intraoperative TEE and valve analysis delimitates a group of patients with high risk of post operative SAM
Summary
SAM is a life threatening condition with up to 20% risk of sudden death. The present study analyses the mitral reconstructions performed by the authors during the last 5 years, from the point of view of preoperative risk for SAM, the appearance rate of post operative SAM and the ways of dealing with it.
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