HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nataf, P. Articles by Gandjbakhch, I. Search for Related Content PubMed PubMed Citation Articles by Nataf, P. Articles by Gandjbakhch, I.

The Annals of Thoracic Surgery, Vol 58, 163-167, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

Intraatrial insertion of a mitral prosthesis in a destroyed or calcified mitral annulus

P Nataf, A Pavie, F Jault, V Bors, C Cabrol and I Gandjbakhch
Department of Thoracic and Cardiovascular Surgery, Hopital de la Pitie, Paris, France.

Infectious lesions and extreme calcification of the mitral valve annulus can make classic anatomic implantation of a prosthesis impossible. Confronted with these circumstances, we have developed a technique of intraatrial insertion of a mitral prosthesis. The prosthesis has been modified by enlarging the circumference of the sewing ring with a Dacron collar. The collar can be sutured to the left atrial wall above the mitral annulus. From 1981 to 1989, this technique has been employed in 36 patients: 15 had acute valve endocarditis with destruction of the mitral annulus and 21 had extensive annular calcification. In all cases, circumferential or partial intraatrial insertion permitted a secure implantation of the prosthesis. One operative death was related to the technique. It was an intractable bleeding caused by tearing of the very thin and fragile wall of the left atrium in a kidney transplant patient. Four patients were reoperated on for periprosthetic leak, in 3 of whom healing and cleaning of the mitral annulus permitted annular implantation of a prosthetic valve. There was no ventricular wall rupture. Our results suggest that the technique can be performed in high operative risk patients when mitral valve replacement is impossible by conventional techniques.

This article has been cited by other articles:

				C. d'Alessandro, N. Vistarini, S. Aubert, F. Jault, C. Acar, A. Pavie, and I. Gandjbakhch Mitral annulus calcification: determinants of repair feasibility, early and late surgical outcome Eur. J. Cardiothorac. Surg., October 1, 2007; 32(4): 596 - 603. [Abstract] [Full Text] [PDF]

				M. Guden, K. Kazimoglu, Y. Sanisoglu, E. Sagbas, R. Yaman, and B. Akpinar The Use of Autologous Pericardium for Complicated Mitral Valve Annulus Asian Cardiovasc Thorac Ann, March 1, 2004; 12(1): 7 - 10. [Abstract] [Full Text] [PDF]

				C. M. Feindel, Z. Tufail, T. E. David, J. Ivanov, and S. Armstrong Mitral valve surgery in patients with extensive calcification of the mitral annulus J. Thorac. Cardiovasc. Surg., September 1, 2003; 126(3): 777 - 781. [Abstract] [Full Text] [PDF]

				A. Kalangos, M. Beghetti, D. Vala, N. Murith, and B. Faidutti Interventricular septal enlargement for left atrioventricular valve replacement with a larger prosthesis J. Thorac. Cardiovasc. Surg., August 1, 2001; 122(2): 382 - 384. [Full Text] [PDF]

				T. E. David, C. M. Feindel, S. Armstrong, and Z. Sun RECONSTRUCTION OF THE MITRAL ANULUSA ten-year experience J. Thorac. Cardiovasc. Surg., November 1, 1995; 110(5): 1323 - 1332. [Abstract] [Full Text]