The “Hybrid Flip-Over” Technique for Anterior Leaflet Prolapse Repair

Mesana, Thierry G.; Ibrahim, Mohanad Kamaleldin Mahmoud; Kulik, Alexander; Ruel, Marc; Dover, K.; Nicholson, Donna; Hynes, Mark

doi:10.1016/j.athoracsur.2006.03.076

Cited by 9 publications

(9 citation statements)

References 7 publications

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“…12 Techniques used to correct anterior leaflet prolapse included chordal transfer, artificial neochord placement, or the hybrid flip-over technique. 13 Resection techniques were preferred for patients with extensive leaflet tissue excess, in particular in patients with a posterior leaflet height >1 cm. In some patients, an edge-to-edge technique was employed, either central or commissural.…”

Section: Operative Techniquementioning

confidence: 99%

Clinical evaluation of functional mitral stenosis after mitral valve repair for degenerative disease: Potential affect on surgical strategy

Mesana

Lam

Chan

et al. 2013

The Journal of Thoracic and Cardiovascular Surgery

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Section: Operative Techniquementioning

confidence: 99%

Clinical evaluation of functional mitral stenosis after mitral valve repair for degenerative disease: Potential affect on surgical strategy

Mesana

Lam

Chan

et al. 2013

The Journal of Thoracic and Cardiovascular Surgery

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“…This may of special interest in case of patients with a growth potential prone to the rapid degeneration and outgrowth of biological or artificial implants. What is the most important, this type of repair concerns only the involved part of the MV and does not jeopardize the rest of the valve which is potentially possible when addressing AML prolapse by the flip-over technique (6). Surgical techniques concerning AML used to be mainly focused on triangular resection of the A2 scallop (7), retention plasty of A1 and A3 (1) and finally commissure plication (4).…”

Section: Resultsmentioning

confidence: 99%

Partial anterior mitral leaflet resection with adjacent ring plication – feasibility pilot study

Antosik¹,

Sologashwilli²,

Pawelec-Wojtalik³

et al. 2016

Medycyna Weterynaryjna

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Valve replacement seems to be the most straightforward option for patients with mitral valve (MV) pathology. However, this approach is connected with all the intrinsic side effects of mechanical or biological valve implantation, including susceptibility to infection, thrombosis and degeneration. Thus, a reconstructive surgery has been recognized as the best option for the majority of patients including children. Many repair techniques have been developed to address mitral valve insufficiency (MI) in case of congenital, ischemic and infective pathologies. The majority of procedures concern the posterior mitral leaflet (PML) and the posterior annulus as well as commissures.The techniques regarding anterior mitral leaflet (AML) and anterior annulus are less frequently utilized in clinical practice as there is a concern of possible distortion of the aortic valve, narrowing of left ventricle outflow tract and unpredictable long-term MV function. Nevertheless, certain interventions on AML were introduced with acceptable results to treat MV systolic anterior motion, degenerative MV disease or Barlow disease (3, 7).Infective and congenital pathologies in children necessitate a search for an alternative reconstructive approach when all procedures utilizing implants (e.g. artificial chordae, pericardial patches) or an opera- Antosik P., Sologashwilli T., Pawelec-Wojtalik M., Wodziński A., Ładziński P., Bartkowska-Śniatkowska A., Bukowska D., Sobieraj M., Nałęcz T., Cudak E., Wojtalik M.Partial anterior mitral leaflet resection with adjacent ring plication -feasibility pilot study Summary The aim of the study was to assess the feasibility and repeatability of a partial removal of the anterior mitral leaflet medial part (AML-A3) accompanied by corresponding anterior mitral annulus plication as a method of valve repair. Four male land race pigs underwent median sternotomy and consecutive cardio-pulmonary by-pass under general anesthesia with hemodynamic monitoring. The AML was detached from the annulus at ⅓ of its length beginning from the postero-median commissure in the direction to the aortic valve and cut off towards the A2-A3 indentation. Three single 3-0 silk sutures were utilized to plicate the mitral annulus segment corresponding with the detached leaflet. The remaining free edge of the AML lateral part was reattached to the plicated ring and to the postero-median commissure with the running 5-0 polypropylene suture. Preoperative and postoperative epicardial echocardiography was performed. All animals survived the operation and were weaned from the cardiopulmonary bypass. All reconstructed MVs were competent. Mean MV diameter decreased after the plasty and did not cause significant diastolic MV flow velocity increase. LVOT anatomy was not altered as well as LVOT flow velocities remained unchanged. The AoV was competent after the operation and did not change its diameter. Partial AML resection completed by corresponding annulus plication is a feasible and repeatable procedure. It does not negatively influence the func...

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“…Anterior leaflet correction included native chordal transfer in 73 (51%) and the hybrid flip-over technique in 23 patients (16%). 11 In brief, the hybrid flip-over technique is used in the setting of bileaflet prolapse. If chordal transfer is not feasible after resection of the posterior leaflet, polytetrafluoroethylene neochordae are placed onto a remnant portion to the posterior leaflet close to the annulus, with subsequent transfer of the posterior leaflet tissue and neochordae to the anterior leaflet.…”

Section: Operative Techniquementioning

confidence: 99%

“…This facilitates measurement of the artificial neochordae to the level of the MV annulus and provides a symmetric line of support to the anterior leaflet. 11 The posterior leaflet is then reconstructed after the sliding plasty. Chordal transfer was the preferred approach to correct anterior leaflet prolapse in this population and was used if secondary chords to the posterior leaflet were not thin, elongated, or calcified.…”

Section: Operative Techniquementioning

confidence: 99%

Clinical and echocardiographic outcomes after repair of mitral valve bileaflet prolapse due to myxomatous disease

Chan

Ruel

Chaudry

et al. 2012

The Journal of Thoracic and Cardiovascular Surgery

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The “Hybrid Flip-Over” Technique for Anterior Leaflet Prolapse Repair

Cited by 9 publications

References 7 publications

Clinical evaluation of functional mitral stenosis after mitral valve repair for degenerative disease: Potential affect on surgical strategy

Clinical evaluation of functional mitral stenosis after mitral valve repair for degenerative disease: Potential affect on surgical strategy

Partial anterior mitral leaflet resection with adjacent ring plication – feasibility pilot study

Clinical and echocardiographic outcomes after repair of mitral valve bileaflet prolapse due to myxomatous disease

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