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Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...

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Updated: Jun 29, 2026

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
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Mitral valve replacement for extensive calcification: half and half technique.

Yasuyuki Bito1, Toshihiko Shibata, Takashi Yasuoka

  • 1Department of Cardiovascular Surgery, Kansai Rousai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan. ybito@med.osaka-cu.ac.jp

General Thoracic and Cardiovascular Surgery
|October 16, 2008
PubMed
Summary

This study presents a novel surgical technique for mitral valve replacement in a patient with severe mitral valve stenosis and extensive calcification. The technique successfully implanted a St. Jude valve in a supra-annular position, offering a viable solution for complex cases.

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Valve Repair
  • Biomaterials in Medicine

Background:

  • Mitral valve stenosis poses significant surgical challenges, particularly when associated with severe calcification of the mitral valve leaflet and annulus.
  • End-stage renal disease patients on long-term hemodialysis often present with complex comorbidities, including advanced calcific valve disease, complicating mitral valve replacement.
  • Traditional mitral valve replacement techniques may be inadequate in cases with extensive posterior annular calcification, necessitating innovative surgical approaches.

Observation:

  • A 50-year-old female patient undergoing long-term hemodialysis presented with severe mitral valve stenosis.
  • Intraoperative findings revealed extreme calcification of the mitral valve leaflet and annulus, rendering removal of the posterior leaflet impossible.
  • A modified surgical technique was employed, utilizing specific suturing methods to accommodate the calcified annulus.

Findings:

  • A supra-annular implantation of a 25-mm St. Jude valve was successfully achieved using a combination of noneverted and everted horizontal mattress sutures.
  • The supra-annular placement and the specific suture technique facilitated secure valve seating despite the challenging calcific anatomy.
  • The St. Jude valve's design, with reduced left ventricular leaflet protrusion, proved advantageous for this supra-annular implantation technique.

Implications:

  • This modified surgical approach offers a potential solution for mitral valve replacement in patients with severe annular calcification, a group often excluded from standard procedures.
  • The successful use of the St. Jude valve in a supra-annular position highlights its adaptability in complex reconstructive cardiac surgery.
  • Further research into this technique could expand treatment options for patients with complex calcific mitral valve disease, improving outcomes in challenging surgical scenarios.