Left Atrial-Left Ventricular Bypass for Congenital Mitral Stenosis

Lansing, Allan M.; Elbl, Francisco; Solinger, Robert; Rees, Allan H.

doi:10.1016/s0003-4975(10)61081-8

Cited by 17 publications

(5 citation statements)

References 2 publications

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“…Еще одним методом хирургического лечения патологии, избегающим прямых манипуляций с кальцинированным фиброзным кольцом, является создание обходного анастомоза между предсердием и верхушкой левого желудочка клапан-содержащим кондуитом. Данная концепция не нова, ее переняли из арсенала лечения атрезии митрального клапана [11]. Методика может быть использована в качестве самостоятельной опции, ограничением, препятствующим широкому применению данной техники, является значительная регургитация на митральном клапане.…”

Section: Discussionunclassified

Immediate outcomes of treatment of severe mitral annular calcification

Муратов

Sorkomov

Sachkov

et al. 2021

RJTAO

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Mitral annular calcification (MAC) is a chronic degenerative process involving the fibrous part of the mitral complex, characterized by calcium deposition and loss of valve function. MAC prevalence is 8–10%, but despite this, the clinical significance of MAC is underestimated. Currently, there are reports that complete decalcification leads to improved long-term outcomes in patients with severe MAC. An analysis of the immediate outcomes of mitral valve surgery in patients with severely calcified mitral annulus with decalcification was performed. The calcified annulus fibrosus underwent complete decalcification in all cases. Calcium deposits were removed in a single block, in 6 cases it was reconstructed with a xeno-pericardial patch; in 2 cases the annulus fibrosus was sutured. There were 2 cases of in-hospital mortality, caused by acute heart failure on day 8 in 1 patient and pulmonary embolism on day 30 after operation in the second patient. There were no complications associated with coronary artery injury and left ventricular posterior wall rupture. Experience in the treatment of severe mitral valve calcification with extensive annulus fibrosus decalcification and subsequent reconstruction is possible and gives satisfactory results.

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Section: Discussionunclassified

Immediate outcomes of treatment of severe mitral annular calcification

Муратов

Sorkomov

Sachkov

et al. 2021

RJTAO

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“…3 The use of extracardiac conduits on the left side has usually been limited to an LV apical-to-aortic conduit for complex LV outflow tract obstruction. 4 LA-to-LV bypass using a valved conduit has been previously described to correct congenital mitral stenosis 5 and as an alternative to MV replacement in the presence of a severely calcified annulus in adults.…”

Section: Discussionmentioning

confidence: 99%

An alternate approach to valve replacement in patients with mitral stenosis and severely calcified annulus

Said

Schaff

2014

The Journal of Thoracic and Cardiovascular Surgery

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A severely calcified mitral annulus represents a unique challenge during mitral valve replacement. To ensure proper healing of the sewing ring of the prosthesis and to avoid periprosthetic regurgitation, the mitral annulus often must be debrided for secure attachment. However, the extensive debridement that can be required in some cases could increase the risk of atrioventricular groove disruption, with a subsequent increase in morbidity and mortality. Bypass of the mitral valve with a left atrial to left ventricular-valved conduit has been described for difficult cases with congenital mitral valve stenosis. In our report, we describe its use as a safe alternative to standard mitral valve replacement in a patient with a densely calcified annulus and severe mitral stenosis.

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“…4 This decreases the gradient across the stenotic mitral valve from diverting blood flow to the mitral valve. This technique was first described in surgery for congenital mitral stenosis 5,6 and later was used by the Mayo Clinic group 7 in acquired mitral stenosis with some modifications: anastomosing the graft from the amputated left atrial appendage to the left ventriculotomy with the valve as close as possible to the left ventricle to eliminate the dead space between the left ventricle and the valve.…”

Section: Saina Attaran MD and Vinod H Thourani Mdmentioning

confidence: 99%