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

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Safety and durability of mitral valve repair for anterior leaflet perforation  Basar Sareyyupoglu, MD, Hartzell V. Schaff, MD, Rakesh M. Suri, MD, DPhil, Heidi M. Connolly, MD, Richard C. Daly, MD, Thomas A. Orszulak, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 139, Issue 6, Pages 1488-1493 (June 2010) DOI: 10.1016/j.jtcvs.2009.07.040 Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Patch repair of mitral valve anterior leaflet perforation through left atriotomy. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1488-1493DOI: (10.1016/j.jtcvs.2009.07.040) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Mitral valve anterior leaflet perforation. A, Transesophageal echocardiographic image shows a mitral valve anterior leaflet perforation (arrow). B, The resultant eccentric mitral valve regurgitation is apparent with color flow imaging. C, The mitral valve anterior leaflet perforation was thought to be due to aortic valve vegetations and the eccentric aortic valve regurgitant jet (diastolic frame) hitting the mitral valve anterior leaflet. D, The result was eccentric mitral valve regurgitation (systolic frame). Ao, Aorta; LA, left atrium; LV, left ventricle. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1488-1493DOI: (10.1016/j.jtcvs.2009.07.040) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Windsock deformity. A, Transesophageal echocardiographic image demonstrates a mitral valve anterior leaflet perforation with a windsock deformity (arrow). B, Color flow imaging shows the resultant eccentric mitral valve regurgitation. LA, Left atrium; LV, left ventricle. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1488-1493DOI: (10.1016/j.jtcvs.2009.07.040) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Repair of mitral valve anterior leaflet windsock deformity. A pericardial patch is placed through the left ventricular outflow tract in a patient undergoing concomitant aortic valve repair for severe aortic regurgitation after endocarditis has healed. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1488-1493DOI: (10.1016/j.jtcvs.2009.07.040) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions