Mitral Valve Repair
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Valvuloplasty
Valvuloplasty is a technique aimed at making sure the flaps of the valves (or
leaflets) close properly, preventing blood from backing up into the atrium. In
the healthy heart, blood flows from the upper chamber (atrium) to the lower
chamber (ventricle), and from the ventricle to the body.
Commissurotomy is a special form of valvuloplasty. Commissurotomy is used when
the leaflets of the valve become stiff and actually fuse together at the base,
which is the ring portion (or annulus) of the valve. Sometimes a scalpel is
used to cut the fused leaflets (commissures) near the ring, which may help them
open and close better. In other cases, a balloon catheter, similar to a
catheter used during angioplasty, is inserted into the valve. The balloon is
inflated, splitting the commissures and freeing the leaflets to open and shut
fully. Unlike other valvuloplasty procedures, this procedure can be done in the
cardiac catheterization lab, and the chest does not have to be opened.
Annuloplasty
Annuloplasty is a technique aimed at repairing the fibrous tissue at the base of
the heart valve (the annulus). Sometimes, the annulus becomes enlarged, which
enables blood to back up into the atrium. To repair this, sutures are sewn
around the ring to make the opening smaller. This creates a purse string effect
around the base of the valve and helps the leaflets meet again when the valve
closes.
Sometimes when repairing the annulus, it is necessary for the surgeon to implant
an annuloplasty ring. A ring is used to correct a problem, provide support for
the valve, and reinforce other repair techniques or any combination of these.
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