ABSTRACT
A 70-year-old man with severe multivalvular disease, atrial fibrillation, and kyphoscoliosis, had Cheyne-Stokes respiration with central sleep apnea. After triple-valve surgery with the maze procedure, adjunctive adaptive servo-ventilation therapy was initiated on the first postoperative day and continued seamlessly in the postoperative period. Seamless adaptive servo-ventilation therapy as an adjunct to triple-valve surgery is more likely to prevent heart failure remodeling without worsening of pulmonary hypertension and recurrence of atrial fibrillation.
Subject(s)
Aortic Valve/surgery , Heart Valve Diseases/surgery , Heart Valve Prosthesis Implantation , Mitral Valve Annuloplasty , Mitral Valve/surgery , Respiration, Artificial/methods , Sleep Apnea, Central/therapy , Tricuspid Valve/surgery , Aged , Aortic Valve/diagnostic imaging , Aortic Valve/physiopathology , Atrial Fibrillation/complications , Atrial Fibrillation/surgery , Catheter Ablation , Echocardiography, Doppler , Heart Valve Diseases/complications , Heart Valve Diseases/diagnosis , Heart Valve Diseases/physiopathology , Heart Valve Prosthesis Implantation/adverse effects , Humans , Male , Mitral Valve/diagnostic imaging , Mitral Valve/physiopathology , Mitral Valve Annuloplasty/adverse effects , Polysomnography , Sleep Apnea, Central/complications , Sleep Apnea, Central/diagnosis , Sleep Apnea, Central/physiopathology , Treatment Outcome , Tricuspid Valve/diagnostic imaging , Tricuspid Valve/physiopathologyABSTRACT
The cases are reported of mitral valve repair with symmetrical papillary muscle approximation from heads to bases close to cardiac apex for functional mitral regurgitation (FMR). The two papillary heads attaching the chordae to both leaflets from the posteromedial papillary muscle were approximated parallel to the solitary head of the anterolateral papillary muscle. This procedure permits an even reduction of lateral shift of the papillary muscle, resulting in an elimination of mitral tethering, and provides a satisfactory and durable mitral valve repair with good outcomes in patients with idiopathic dilated cardiomyopathy and FMR.
Subject(s)
Cardiac Surgical Procedures/methods , Cardiomyopathy, Dilated , Chordae Tendineae/surgery , Mitral Valve Insufficiency , Mitral Valve , Papillary Muscles/surgery , Aged , Cardiomyopathy, Dilated/complications , Cardiomyopathy, Dilated/diagnosis , Cardiomyopathy, Dilated/physiopathology , Cardiomyopathy, Dilated/surgery , Echocardiography, Doppler, Color/methods , Female , Humans , Intraoperative Period , Male , Middle Aged , Mitral Valve/diagnostic imaging , Mitral Valve/surgery , Mitral Valve Insufficiency/diagnosis , Mitral Valve Insufficiency/etiology , Mitral Valve Insufficiency/physiopathology , Mitral Valve Insufficiency/surgery , Treatment OutcomeABSTRACT
The present report describes a simple modification to the reinforcement technique by Copeland et al. using autologous pericardium for the Bentall procedure. Our modified technique may decrease the probability of leaks at the aortic root. Further, this technique preserves the advantages of the Valsalva graft, including tension-free coronary anastomosis and anatomical adaptability.
