OBJECTIVE Permanent atrial fibrillation (pAF) is a serious problem in cardiac surgery: An incidence of 3.5% among all patients scheduled for open heart surgery, 9.8% in heart valve cases and 45.6% among patients with severe rheumatic mitral valve (MV) disease was observed in our institution. Our experience with radiofrequency (RF) ablation procedures to treat pAF in these cases is reported. M...

The gold standard treatment of degenerative mitral valve disease remains surgical repair. The classic repair described by Dr. Carpentier (1) with leaflet resection and annuloplasty remains the primary technique for mitral repair. Other techniques such as the “American correction” (2) or artificial chordae have been introduced with similar success rates. Innovations in surgical approach over the...

Relevant secondary mitral regurgitation occurs in 35– 50% of patients with chronic heart failure and is associated with increased mortality. Surgical management of patients with mitral valve regurgitation and heart failure remains controversial. There are several questions which are not sufficiently clarified because of a lack of prospective randomised controlled trials: (1.) The indication for...

Several techniques are currently in use for mitral valve reconstruction. We report a mitral repair case in which the use of a combination of different surgical techniques resulted in the necessary correction. A 47-year-old woman underwent surgical intervention to treat severe mitral valve insufficiency due to A1/A2/A3 and P2 prolapsed valve tissue. A combination of quadrangular resection, slidi...

Fibrin glue is used for control of bleeding in various surgical procedures. In this work the ability of fibrin glue to seal punctures in the vascular system is demonstrated. Blood samples were taken from rabbits, fibrinogen was separated and fibrin glue was eventually prepared. The rabbits were anesthetized and a midline incision was carried out. The heart and abdominal aorta were exposed. ...

The role of intraoperative transesophageal echocardiography (TEE) has increased tremendously since its first use in 1979. Today intraoperative TEE is a class I indication for surgical mitral valve reconstruction for evaluation of mitral valve pathology, graduation of mitral regurgitation and detection of potential risk factors as well as post-repair assessment. Real-time three-dimensional TEE o...

Introduction: After early successful experience with transcatheter aortic valve replacement (TAVR), concept of transcatheter implantation of a new valve within a failing bioprosthetic valve emerged. Valve-in-valve (ViV) implantation seems to be a simpler option for high risk surgical patients. Methods: We performed five ViV procedures in different valve positions. We included patients with fail...

Introduction: Surgical valve replacement is not always feasible in patients with severe mitral regurgitation from a failing bioprosthetic valve or severe mitral annular calcification. Off-label use of transcatheter aortic valves has been described in the literature as a possible method of valve replacement for this patient population. We review the literature on this practice as well as present...

valvuloplasty can be performed safely and with satisfactory results in over 85% of these patients. It is also possible that repeat PMV can be performed in these patients with acceptable risks and results. In our own single centre experience in about 390 procedures repeat percutaneous balloon valvuloplasty was performed in 17 cases (mean age 65 13 years) without any increase in the rate of acute...

308 As technology advances resulted in more effective percutaneous approaches to the treatment of valvular stenosis, the terminology used to describe these procedures evolved as well. The term “commissurotomy” originated from the surgical procedure developed for commissural mitral valve stenosis (see chapter 34), and some thought valvuloplasty should be reserved for surgical procedures that mor...