Reconstruction of fibrous skeleton: technique, pitfalls and results
Gösta B Pettersson1, Syed T Hussain2, Rajesh M Ramankutty2
1Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA petterg@ccf.org.
Abstract:
Destruction of the mitral-aortic (or mitroaortic) intervalvular fibrosa (IVF) by infective endocarditis is a marker of advanced pathology. Patients are at high risk, as they are sicker, have more comorbidities and have more advanced pathology, requiring a difficult operation that includes debriding and reconstructing the IVF. The anatomy and surgical techniques for that reconstruction are presented and discussed. Operative risk is high and remains high for the first year, before becoming equivalent to that of conventional operations for endocarditis. Current outcomes are better than in the past, but there is room for further improvement.
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