Native Mitral Leaflets Research Articles

How To Do It: Mitral Valve Translocation.

Mitral valve translocation (MVT) is a novel procedure that was developed to treat patients with severe, symptomatic, secondary mitral regurgitation (MR). MVT enhances leaflet coaptation by insertion of an autologous pericardial patch interposed between the mitral annulus and the native mitral leaflets. The patch substantially increases total leaflet surface area and creates supranormal coaptation. In addition, it relieves leaflet tethering by transposing the native valve deeper into the ventricle and decreases the circumference of the annulus. The enhanced coaptation produced by MVT may protect against recurrent MR in patients with continued adverse left ventricular remodeling. The procedural steps include detachment of the intact native mitral valve at the annulus, placement of interrupted pledgeted sutures around the annulus to secure the proximal aspect of the patch, and attachment of the native valve to the distal aspect of the patch using running suture. Follow-up of patients who have undergoing MVT is ongoing, with satisfactory short-term results, including sustained MR grades of ≤mild and 14 mm coaptation at 12 months.

Transaortic Correction of Systolic Anterior Motion of the Mitral Leaflet After Aortic and Mitral Valve Replacement

Left ventricular outflow tract obstruction is a rare and critical complication after mitral valve replacement. We report a patient who presented with severe left ventricular outflow tract obstruction caused by systolic anterior motion of the native mitral leaflet after aortic and mitral valve replacement. The patient was successfully treated by resection of the anterior mitral leaflet through the 19-mm bioprosthetic valve in the aortic position. This approach is quite simple and effective, even through the small aortic bioprosthesis, and does not require a second mitral valve replacement.