Mobilization of the left and right fibrous trigones for relief of severe left ventricular outflow obstruction Magdi Yacoub, FRCS, FRCP, Obed Onuzo, MRCP,

Slides:

Advertisements

Similar presentations

Two-dimensional echocardiogram from a patient with severe hypertrophic cardiomyopathy. There is a severe increase in left ventricular wall thickness, with.

Advertisements

Surgical treatment of subaortic stenosis after biventricular repair of double-outlet right ventricle Emre Belli, MD, Alain Serraf, MD, François Lacour-Gayet,

Lindsay S. Rogers, MD, Amy L. Peterson, MD, J

The left ventricular outflow tract in atrioventricular septal defect revisited: Surgical considerations regarding preservation of aortic valve integrity.

What's in a Mass?: Large Native Mitral Valve Mass

Fixed versus dynamic subaortic stenosis: Hemodynamics and resulting differences in Doppler echocardiography and aortic pressure contour Joon Hwa Hong,

Novel mechanism of mitral regurgitation after lung transplantation in a patient with scleroderma and pulmonary hypertension Christian A. Bermudez, MD,

Incomplete midline atrial chamber in a symptom-free adult: An enigma?

Coronary artery-to-left ventricular fistula

Accurate Localization of Mitral Regurgitant Defects Using Multiplane Transesophageal Echocardiography Gary P. Foster, Eric M. Isselbacher, Geoffrey A.

Aortico-Left Ventricular Tunnel: Diagnosis Based on Two-Dimensional Echocardiography, Color Flow Doppler Imaging, and Magnetic Resonance Imaging RICHARD.

Prosthetic Mitral Valve Replacement: Late Complications After Native Valve Preservation Eduardo Esper, MD, Francis D Ferdinand, MD, Solomon Aronson,

N. Ad, MDa, E. Birk, MDb, J. Barak, MDa, S. Diamant, MDc, E

The practical clinical value of three-dimensional models of complex congenitally malformed hearts Eugénie Riesenkampff, MD, Urte Rietdorf, MSc, Ivo Wolf,

Thrombosis of the pulmonary artery stump after distal ligation

B. Albat, MD, P. Messner-Pellenc, MD, A. Thévenet, MD

Aortic root translocation with atrial switch: Another surgical option for congenitally corrected transposition of the great arteries with isolated pulmonary.

Klaus Langes, MD, Dietmar Koschyk, MD, Detlef G. Mathey, MD

Spontaneous giant right coronary artery pseudoaneurysm

Morphologic Spectrum of Ventriculoarterial Connection in Hearts With Double Inlet Left Ventricle: Implications for Surgical Procedures Hideki Uemura,

Volume 81, Issue 1, Pages (January 1982)

Idiopathic Hypertrophic Subaortic Stenosis

Beyond Extended Myectomy for Hypertrophic Cardiomyopathy: The Resection- Plication-Release (RPR) Repair Sandhya K. Balaram, MD, PhD, Mark V. Sherrid,

Ventricular thrombus and subarachnoid bleeding during support with ventricular assist devices Eva M Gruber, MD, Rainald Seitelberger, MD, Peter Mares,

Left ventricular inflow obstruction associated with persistent left superior vena cava and dilated coronary sinus Daniel J DiBardino, MD, Charles D Fraser,

One-stage repair of interrupted aortic arch, ventricular septal defect, and subaortic obstruction in the neonate: A novel approach Giovanni Battista.

Maura Steed, BS, Vitor Guerra, MD, PhD, Michael R

Accessory mitral valve tissue causing severe left ventricular outflow tract obstruction in an adult Yoshikazu Aoka, MD, Naoko Ishizuka, MD, PhD, Yasunari.

Aneurysm of Sinus of Valsalva Dissecting Into Interventricular Septum

Zohair Al Halees, MD, Mahmoud M. Awad, MD, Frans Pieters, MD, Maie S

Martin H. Chamberlain, FRCS, David P. Taggart, MD, FRCS

Transposition of the great arteries {S, D, L}

Predicting recurrent mitral regurgitation after mitral valve repair: A difficult endeavor and a necessity Denis Bouchard, MD, Louis P. Perrault, MD,

Subaortic stenosis in the spectrum of atrioventricular septal defects

Aortic Elongation Induced Aortic Stenosis (AEAS)

Factors affecting late survival after surgical remodeling of left ventricular aneurysms Hooshang Bolooki, MD, Eduardo DeMarchena, MD, Stephen M Mallon,

Robot-assisted septal myectomy for hypertrophic cardiomyopathy with left ventricular outflow tract obstruction Zain Khalpey, MD, PhD, MRCS (Eng), Lev.

A new concept for correction of systolic anterior motion and mitral valve regurgitation in patients with hypertrophic obstructive cardiomyopathy Joerg.

Qingyu Wu, MD, Lufeng Zhang, MD, Rui Zhu, MD

Anatomic correction of the syndrome of prolapsing right coronary aortic cusp, dilatation of the sinus of valsalva, and ventricular septal defect Magdi.

Freddy Vermeulen, MD, Ben Swinkels, MD, Wim Jan van Boven, MD

Subvalvular aortic stenosis: Comprehensive cardiac evaluation with dual-source computed tomography Paul Stolzmann, MD, Hans Scheffel, MD, Dominique Bettex,

Pulmonary root translocation for biventricular repair of double-outlet left ventricle with absent subpulmonic conus Doff B. McElhinney, MS, V.Mohan Reddy,

Monobloc aorto-mitral homograft as a treatment of complex cases of endocarditis Jean-François Obadia, MD, PhDa, Olivier Raisky, MDa, Laurent Sebbag, MDa,

Mitral valve replacement for inflow obstruction of left ventricular assist device in a child with restrictive cardiomyopathy Hari Tunuguntla, MD, Susan.

Modified Rastelli procedure for double outlet right ventricle with left-malposition of the great arteries: report of 9 cases Qingyu Wu, MD, Qibin Yu,

Albert Starr, MD, Hagop Hovaguimian, MD

Fixed left ventricular outflow tract obstruction in presumed hypertrophic obstructive cardiomyopathy: implications for therapy Charles J Bruce, MB, Rick.

Patient recovery after intermittent disc escape and spontaneous recession of a mechanical heart valve Francis Robicsek, MD, PhD, Joseph W. Cook, MD

Autograft from quadrangular resection for floppy valve repair in endocarditis Alfonso Penta de Peppo, MD, Jacob Zeitani, MD, Ruggero De Paulis, MD, Luigi.

Double-Root Translocation for Double-Outlet Right Ventricle With Noncommitted Ventricular Septal Defect or Double-Outlet Right Ventricle With Subpulmonary.

Systolic Anterior Motion Obstructing the Pulmonary Outflow Tract After Tricuspid Valve Replacement Bilal H. Kirmani, MRCS, Ijas Moideen, FRCA, Pedro.

Mitral Stenosis Associated With Valvular Tophi

AORTIC VALVE–PRESERVING PROCEDURE FOR ENLARGEMENT OF THE LEFT VENTRICULAR OUTFLOW TRACT AND MITRAL ANULUS Richard A. Jonas, MD, John F. Keane, MD, James.

Elspeth M. Brown, MRCP, Anthony P. Salmon, FRCP, Robert K. Lamb, FRCS

Successful myocardial volume reduction in a 9-month-old infant

Preserving the V-engine shape of the left ventricle with Melody mitral valve replacement in small children Patrick O. Myers, MD The Journal of Thoracic.

Ventricular remodeling and mitral valve modifications in dilated cardiomyopathy: New insights from anatomic study Alexandre Ciappina Hueb, MD, Fabio.

Left Ventricular Outflow Tract Obstruction After Transcatheter Mitral Valve-in-Ring Implantation: A Word of Caution Sameh M. Said, MD, Sorin Pislaru,

The Surgical History, Management, and Outcomes of Subaortic Stenosis in Adults Michael Ibrahim, MA (Cambridge), Martin Kostolny, MD, Tain-Yen Hsia, MD,

Transient dysfunction of the freestyle stentless xenograft

Basar Sareyyupoglu, MD, Hartzell V. Schaff, MD, Rakesh M

Homograft valve repair for recurrent prosthetic valve endocarditis

Ectopic thyroid tissue in the left ventricular outflow tract

Mechanical left ventricular unloading to prevent recurrent myocardial rupture Stephen Westaby, MS, PhD, Vipin Mehta, MD, Fidelma Flynn, MD, Neil Wilson,

Complete excision of secondary chordae of the anterior mitral leaflet as an adjunct in surgical management of hypertrophic obstructive cardiomyopathy.

Lipomatous septal hypertrophy

Echo-free perfused spaces: A current postoperative finding after homograft replacement of the aortic valve T. Carrel, MD, M. Pasic, MD, E. Oechslin,

Filip Casselman, MD, PhD, FETCS, Hugo Vanermen, MD, FETCS

David A. Theodoro, MDa, Gordon K. Danielson, MDa, Robert H

Presentation transcript:

Mobilization of the left and right fibrous trigones for relief of severe left ventricular outflow obstruction Magdi Yacoub, FRCS, FRCP, Obed Onuzo, MRCP, Bernhard Riedel, FCA (SA), Rosemary Radley-Smith, FRCP The Journal of Thoracic and Cardiovascular Surgery Volume 117, Issue 1, Pages 126-133 (January 1999) DOI: 10.1016/S0022-5223(99)70477-0 Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 1 The diagram shows the position of inflow and outflow valves, which share the same orifice in ventricle (A) in contrast to the arrangement in right ventricle, where the 2 valves are located at 2 ends of muscular tube (B). The Journal of Thoracic and Cardiovascular Surgery 1999 117, 126-133DOI: (10.1016/S0022-5223(99)70477-0) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 2 The diagrams show (B and C) the interaction between the mitral and aortic orifices, with the 2 fibrous trigones acting as a hinge mechanism for the movement of the subaortic curtain and anterior leaflet of the mitral valve during different phases of the cardiac cycle and (A) the structures surrounding the LVOT. The Journal of Thoracic and Cardiovascular Surgery 1999 117, 126-133DOI: (10.1016/S0022-5223(99)70477-0) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 3 A-D, The diagrams show the anatomic location of the different types of fixed subaortic stenosis. The Journal of Thoracic and Cardiovascular Surgery 1999 117, 126-133DOI: (10.1016/S0022-5223(99)70477-0) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 4 Photograph of the LVOT in a patient with subaortic stenosis shows the relationship between the fibrous shelf and the fibrous trigone. The Journal of Thoracic and Cardiovascular Surgery 1999 117, 126-133DOI: (10.1016/S0022-5223(99)70477-0) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 5 Echocardiogram shows (A) the anterior component of the subaortic stenosis, (B) postoperative transesophageal echocardiogram of the LVOT during systole and diastolic, and (C) the mobilized hinge mechanism of the right and left fibrous trigones. RV, Right ventricle; LV, left ventricle; Ao, aorta; MV, mitral valve; LA, left atrium. The Journal of Thoracic and Cardiovascular Surgery 1999 117, 126-133DOI: (10.1016/S0022-5223(99)70477-0) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 6 A photocopy of an excised specimen of subaortic stenosis shows the different components, including the fibrous tissue adjacent to the right and left fibrous trigones, and the resected wedges from the muscular interventricular septum. The Journal of Thoracic and Cardiovascular Surgery 1999 117, 126-133DOI: (10.1016/S0022-5223(99)70477-0) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 7 A-G, Diagrams show the different steps of surgical relief of fixed subaortic stenosis with mobilization of the fibrous trigones (see text for details). The Journal of Thoracic and Cardiovascular Surgery 1999 117, 126-133DOI: (10.1016/S0022-5223(99)70477-0) Copyright © 1999 Mosby, Inc. Terms and Conditions