Repair of atrioventricular disruption after mitral valve replacement utilizing commando procedure principles

Abstract

Atrioventricular (AV) rupture is a life-threatening complication of mitral valve replacement. We present how incising the intervalvular fibrosa critically improves exposure. The aortic valve sacrifice allows access to a large AV dissociation defect and reliable repair of the anterolateral aspect of mitral valve annulus.

When too much closeness harms: circumflex artery injury during mitral valve surgery

“…Venous grafting is also more likely to be preferred if some time has already elapsed due to unsuccessful PCI and the patient needs to be emergently taken back to the OR. In any case of surgical solution of coronary artery occlusion, it should be kept in mind that in these patients excessive lifting of the heart may provoke atrioventricular rupture, which is deleterious with high probability ( 42 , 43 ). This is important in the presence of calcification of the annulus and an application of a full annuloplasty ( 44 ).…”

An ounce of prevention is worth a pound of cure

“…Raevsky et al present a case report of a 23-year-old female with shone complex, who developed atrioventricular groove disruption after mitral valve replacement. To accomplish the repair and because of difficult exposure, they had to utilize ‘the commando procedure principles’, sacrificing the native ‘bicuspid’ aortic valve [ 3 ].…”