The aim of this study is to present the crossed papillopexy technique using bovine pericardial graft in mitral replacement caused by intense valvar and subvalvar fibrosis and calcification. This technique allows the functional preservation of the mitral subvalvar apparatus and was successfully applied, by the first time as far as we known, in a patient with calcified rheumatic mitral stenosis, who underwent mitral valve replacement surgery. The patient had an uneventful recovery and was discharged home on postoperative day 6. Echocardiography controls showed normal left ventricular function without any interference on the mitral prosthesis dynamics.Descriptors: Mitral valve/surgery. Papillary muscles/ surgery. Heart valve prosthesis. ResumoO objetivo deste artigo é mostrar a técnica da papilopexia cruzada com o uso de enxerto de pericárdio bovino na substituição mitral por fibrose e calcificação intensa valvar e subvalvar. Esta técnica permite a preservação funcional do aparelho subvalvar mitral e foi aplicada pela primeira vez, na literatura alcançada, em paciente portador de estenose mitral reumática calcificada, submetido a troca valvar mitral. O paciente evoluiu sem complicações, com alta hospitalar em seis dias. Controles ecocardiográficos mostraram função ventricular esquerda preservada sem interferência na dinâmica da prótese mitral. Descritores: Valva mitral/cirurgia. Músculos papilares/ cirurgia. Próteses valvulares cardíacas.This study was carried out at the Cordis
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