Related Experiment Video

Updated: Jun 15, 2026

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

1.5K

Repairing the mitral valve without touching the mitral valve-a novel technique

Daniel Sitaranjan1, Ujjawal Kumar1,2, Fadi Al-Zubaidi1

  • 1Department of Cardiac Surgery, Royal Papworth Hospital, Papworth Road, Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0AY, United Kingdom.

Journal of Surgical Case Reports
|January 13, 2025
PubMed

Insights

Severe left ventricular aneurysm and mitral regurgitation were successfully treated with aneurysmectomy and geometric restoration, improving cardiac function. This approach avoided direct mitral valve intervention, showcasing its efficacy in complex cardiac cases.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Cardiovascular Imaging

Background:

  • Severe ischemic cardiomyopathy and mitral regurgitation pose significant clinical challenges.
  • Left ventricular aneurysms can lead to heart failure and thromboembolic events.
  • Accurate diagnosis relies on advanced imaging like echocardiography and MRI.

Observation:

  • A 44-year-old male presented with a large left ventricular aneurysm (9.3 x 9.5 cm) and severe mitral regurgitation post-myocardial infarction.
  • Imaging revealed a dilated left ventricle, thrombus within the aneurysm, and significant leaflet tethering causing mitral regurgitation.
  • Pre-operative left ventricular ejection fraction was markedly reduced at 25%.

Findings:

  • The patient underwent successful aneurysmectomy with patch repair and papillary muscle approximation.
  • Postoperatively, temporary veno-arterial extracorporeal membrane oxygenation (ECMO) support was required for 6 days.
  • The patient was discharged with improved left ventricular ejection fraction (45%) and only trace mitral regurgitation.

Implications:

  • Geometric restoration of the left ventricle can effectively address severe mitral regurgitation secondary to aneurysm.
  • This surgical strategy offers a viable alternative to conventional mitral valve repair or replacement in select cases.
  • Successful management highlights the importance of addressing ventricular remodeling in ischemic heart disease.

Keywords:
geometric restorationischemic cardiomyopathyleft ventricular aneurysmmitral regurgitation

More Related Videos

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair08:31

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

3.8K
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

14.0K

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 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...
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 Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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 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...