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Beating-heart, off-pump mitral valve repair by implantation of artificial chordae tendineae: An acute in vivo animal study  Pietro Bajona, MD, William.

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Presentation on theme: "Beating-heart, off-pump mitral valve repair by implantation of artificial chordae tendineae: An acute in vivo animal study  Pietro Bajona, MD, William."— Presentation transcript:

1 Beating-heart, off-pump mitral valve repair by implantation of artificial chordae tendineae: An acute in vivo animal study  Pietro Bajona, MD, William E. Katz, MD, Richard C. Daly, MD, Kenton J. Zehr, MD, Giovanni Speziali, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 137, Issue 1, Pages (January 2009) DOI: /j.jtcvs Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Schematic drawing of the surgical technique. A, The instrument is inserted in the LV cavity and new ACT is implanted on the MV leaflet. B, ACT in place and secured outside the LV apex. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 The open tip of the instrument with the sliding mechanism and the harpoon-tipped needle. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Instrument and fiberoptics. A, Opened tip of the instrument with enlighten fiberoptics. B, No valve tissue grasped. Four red dots resulted from the direct contact of the fiberoptics with the blood. C, MV tissue grasped. The fiberoptics contacting the tissue turned white. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 ACTs tensioning. A, Neoimplanted, nontensioned ACTs with MR. B, ACT length judged in real time by observing reduction or disappearance of MR with color Doppler echocardiogram. Ao, Aorta; LA, left atrium; LV, left ventricle; ACT, artificial chordae tendineae. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

6 Figure 5 Surgical procedure highlights. A, MV eccentric jet is demonstrated by color Doppler sonography after cutting native chordae. B, Instrument ws inserted in the LV and grabbed the MV anterior leaflet. C, ACT in place after instrument withdrawal. D, Final result with no residual MR after ACT tensioning. Ao, Aorta; LA, left atrium; LV, left ventricle; ACT, artificial chordae tendineae. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

7 Figure 6 Postoperative inspection of valvular and subvalvular apparatus and newly implanted ACTs. A, Open view of the LV with two native chordae cut, an implanted ACT and LV apex with pledget-supported purse-string suture, and ACT anchorage. B, LV apical view of the MV with one native chordae cut and an implanted ACT. NC cut, Native chordae cut; ACT, artificial chordae tendinae; PML, posterior mitral valve leaflet; AML, anterior mitral valve leaflet; LV apex, left ventricular apex. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

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