By Choi-Keung Ng
Preoperative and intraoperative echocardiography has turn into an necessary device for steering mitral valve surgical procedure and has fostered the advance of many leading edge surgical recommendations. Mitral valvuloplasty is now a longtime surgical procedure for the therapy of mitral insufficiency however the good fortune is basically depending on the level of the underlying disorder of the mitral valve. The booklet through Dr. Ng and coauthors is a rare presentation of the relation among echocardiographic show of mitral valve pathology and reconstructive mitral valve surgical procedure. The atlas offers a great illustrative advisor to coach echocardiographic-anatomic correlations and educates the reader at the strategies of mitral valve fix. the standard of the illustrations, rather the surgical images is beautiful. The booklet might be important for cardiologists and cardiac surgeons.
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Extra info for Modern Mitral Valve Repair: Echocardiographic Interpretations and Surgical Strategies
The TEE examination usually shows a flail leaflet or a prolapse of both leaflets. Color Doppler often reveals an oblique, eccentric regurgitation jet between the two leaflets (Fig. 1-2). 3 Destruction of commissures In cases of infective endocarditis, destruction of commissures, regardless of the side that is affected, is always followed by severe mitral regurgitation. The dysfunction affects both leaflets simultaneously and is frequently accom- 38 Mitral valve surgery for complications of endocarditis FIG.
1. 6 Paracommissural extension patch plasty (Fig. 20) In another patient the commissural area had to be filled with a crescent -shaped patch because FIGS. 3. The short-axis view TTE is advantageous. Here it displays the severity of the main pathology at the posteromedial commissure, vegetation, tissue destruction and severe mitral regurgitation 42 of tissue shrinkage after rheumatic endocarditis, tissue destruction with perforation or colonization and vegetations as a result of bacterial processes, or even after anterior and posterior leaflet prolapse owing to ruptured commissural chordae.
1, 2 is an example of postendocarditic perforations in the anterior and posterior leaflet. Preoperatively, the perforations were confirmed on the color Doppler TTE apical longitudinal section as two narrow excentric jets. This was useful for informing the patient preoperatively and in surgical planning. 3-6 shows a post-endocarditic ulceration in the anterior leaflet on the TEE modified long-axis view with two different regurgitation jets on color Doppler. The main stream was due to the coaptation gap, while the narrow jet was presumed to be the result of a severe ulceration defect in the anterior leaflet.
Modern Mitral Valve Repair: Echocardiographic Interpretations and Surgical Strategies by Choi-Keung Ng