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Sunil Ohri
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J Thorac Cardiovasc Surg 2009;138:773-774
© 2009 The American Association for Thoracic Surgery

Brief Technique Report

Video-assisted cardioscopy in the repair of persistent mitral paraprosthetic leak

Narain Moorjani, MD, FRCS*, Jack Broadhurst, MB ChB, Sunil Ohri, MD, FRCS

Department of Cardiothoracic Surgery, Southampton General Hospital, Southampton, United Kingdom

Received for publication May 8, 2008; accepted for publication May 25, 2008.

* Address for reprints: Narain Moorjani, MD, FRCS, c/o Mr S Ohri's secretary, Department of Cardiothoracic Surgery, Southampton General Hospital, Southampton, SO16 6YD, United Kingdom. (Email: narain.moorjani@doctors.org.uk).

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


   Introduction
 
Paraprosthetic leak after mitral replacement varies between 2% and 17%. The risk factors implicated in its cause include continuous suture techniques, annular calcification, and replacement in the presence of infective endocarditis. Although several surgical treatment options exist, including direct suturing, suturing an autologous pericardial patch, or rereplacement, each can be associated with recurrence. This is in part due to the access to the mitral valve annulus in patients undergoing redo mitral surgery. In this case report such a patient with a recurrent mitral paraprosthetic leak is described, in whom use of intraoperative video-assisted cardioscopy aided the closure of a paraprosthetic lesion.


   Clinical Summary
 
Ten years previously, a 72-year-old man had been given a diagnosis of severe mitral regurgitation caused by the flail P2 segment of his posterior mitral valve leaflet. This was initially treated with quadrangular resection of P2 and sliding annuloplasty. Unfortunately, in the postoperative period, moderate mitral regurgitation was observed, and the valve was replaced with a 27-mm mechanical prosthesis (St Jude, St Paul, . . . [Full Text of this Article]






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