How to treat systolic anterior motion of the anterior mitral valve leaflet during endoscopic minimally invasive surgery.

Q4 Medicine

Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2024-09-24 DOI:10.1510/mmcts.2024.060

Gianpiero Buttiglione, Can Gollmann-Tepeköylü, Lukas Stastny, Leo Pölzl, Clemens Engler, Daniel Höfer, Michael Grimm, Nikolaos Bonaros

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Abstract

Systolic anterior motion is characterized by the displacement of the anterior mitral leaflet towards the left ventricle outflow tract. Iatrogenic systolic anterior motion occurs after mitral valve repair as a result of mitral annuloplasty. Possible causes include excess height of a redundant posterior mitral leaflet and/or the use of an undersized ring. The condition is usually diagnosed after weaning from cardiopulmonary bypass by transoesophageal echocardiography. Apart from conservative measures, the treatment of systolic anterior motion may require the restoration of cardiopulmonary bypass and further surgical valve repair. Strategies for systolic anterior motion correction include an edge-to-edge repair or the use of a larger annuloplasty ring. In this tutorial, we present two ways of reducing posterior leaflet height as a simple option to move the leaflet coaptation more posteriorly.

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如何在内窥镜微创手术中治疗二尖瓣前叶收缩期前移。

收缩期前移的特点是二尖瓣前叶向左心室流出道移位。二尖瓣环成形术导致二尖瓣修复后出现先天性收缩期前移。可能的原因包括多余的二尖瓣后叶高度过高和/或使用了过小的环。这种情况通常在心肺旁路术后通过经食道超声心动图检查确诊。除保守治疗外，收缩期前移的治疗可能需要恢复心肺旁路和进一步的瓣膜修复手术。收缩期前移矫正策略包括边缘到边缘修复或使用较大的瓣环成形术。在本教程中，我们将介绍两种降低瓣叶后部高度的方法，这是一种将瓣叶瓣合更向后移动的简单选择。

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来源期刊

Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Medicine-Medicine (all)

CiteScore

0.60

自引率

0.00%

发文量

期刊介绍： The Multimedia Manual of Cardio-Thoracic Surgery (MMCTS) is produced by The European Association for Cardio-Thoracic Surgery (EACTS). MMCTS is the world’s premier video-based educational resource for cardiovascular and thoracic surgeons; freely accessible - and essential - for all. MMCTS was launched more than ten years ago under the leadership of founding editor Professor Marko Turina. It was Professor Turina’s vision that the European Association for Cardio-Thoracic Surgery (EACTS), already the world-leader in CT surgery education, should take advantage of the Internet’s rapidly improving video publication capabilities and create a new step-by-step manual of surgical procedures. Professor Turina and EACTS agreed that the manual, MMCTS, should be freely accessible to all users, regardless of association membership status, nationality, or affiliation. MMCTS was self-published by EACTS for some years before being transferred to Oxford University Press, which hosted it until the end of 2016. In November 2016, the Manual returned home to EACTS and it has now relaunched in a completely new format. Since its birth in 2005, MMCTS has published some 400 detailed, video-based demonstrations of cardio-thoracic surgical procedures. Tutorials published prior to 2012 have been archived and we are working with the authors of these tutorials to update their work pending republication on the new site. Our mission is to make MMCTS the best online reference for cardio-thoracic surgeons – residents and experienced surgeons alike. Our aim is to include tutorials presenting procedures at both a fundamental and an advanced level. Truly innovative procedures are also included and are identified as such.