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J Thorac Cardiovasc Surg 2007;133:1635-1636
© 2007 The American Association for Thoracic Surgery

Brief Communication

The intraoperative "ink test": A novel assessment tool in mitral valve repair

Department of Cardiothoracic Surgery, Mount Sinai Hospital, New York, NY.

Received for publication December 7, 2006; revisions received December 22, 2006; accepted for publication January 8, 2007.

^_* Address for reprints: David H. Adams, MD, Department of Cardiothoracic Surgery, Mount Sinai Medical Center, 1190 Fifth Ave, Box 1028, New York, NY 1028. (Email: David.Adams@mountsinai.org).

The first 20% of the full text of this article appears below.

Mitral valve repair is the established therapy of choice for most patients with mitral regurgitation. Assessment of repair quality traditionally relies on visual inspection, saline testing, and transesophageal echocardiography (TEE). Although invaluable in assessing valve competency, the saline test is limited because it does not provide confirmation of the surface of coaptation; a valve that is competent on saline testing might actually have a minimal surface of coaptation or excess anterior leaflet tissue below the closure line. Although TEE might demonstrate such imperfections (specifically inadequate zone of coaptation or a tendency for systolic anterior motion), there is an understandable reluctance to reinstitute cardiopulmonary bypass to address such TEE findings if the valve is otherwise competent. Such a strategy, however, leaves some patients with an inadequate surface of coaptation and might be one explanation for recurrent mitral regurgitation.¹ There is a need for a technique that allows the surgeon to confirm the amount of leaflet tissue below the valve closure line before weaning from cardiopulmonary bypass. We describe a simple "ink test," which allows . . . [Full Text of this Article]

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