The aortic valve is one component of the aortic root, which connects the left ventricular outflow tract to the ascending aorta. The function of the aortic root is to guide the unidirectional flow of large volumes of blood with minimal…
Reconstruction of the tricuspid valve should be guided by the same basic principles described for the mitral valve—that is, preserving or restoring normal leaflet motion, ensuring a large surface of leaflet coaptation, and remodeling the dilated and deformed annulus. The…
The pathophysiological triad introduced for the mitral valve ( Chapter 6 ) is also relevant to the other valves, including the tricuspid valve. It provides an accurate description of the valve pathophysiology by a clear separation between etiology, lesions, and…
The tricuspid valve is part of a complex functional system that also includes the right atrium, the right ventricle, and the pulmonary circulation. With the tricuspid valve exposed, the surgeon observes sequentially the right atrial cavity, the atrio-valvular junction, the…
Patients undergoing mitral valve reconstruction often require additional procedures to address the following associated disorders: left atrial thrombus formation, atrial calcification, giant left atrium, and atrial fibrillation. LEFT ATRIAL THROMBUS FORMATION Thrombus formation in the left atrium ( Fig. 16-1…
The term “Systolic Anterior Motion” (SAM) defines a systolic displacement of the distal portion of the anterior leaflet of the mitral valve towards the outflow tract of the left ventricle (LV). This abnormal motion, first described in “muscular subvalvular aortic…
The most important functional characteristic of type IIIb dysfunction, compared to type IIIa, is a pure systolic restricted leaflet motion with preserved leaflet pliability. The most common causes of this dysfunction are ischemic myocardial disease, idiopathic dilated cardiomyopathy, and end-stage…
The great majority of valvular diseases with diastolic-restricted leaflet motion have a rheumatic origin. The limitation of the motion of the leaflets is due to commissural fusion, leaflet thickening, chordae fibrosis, and occasionally calcifications. These lesions produce either pure mitral…
A commissural leaflet prolapse is a valve dysfunction typically seen in bacterial endocarditis or in degenerative valvular diseases. The cause of the prolapse is either chordae rupture in bacterial endocarditis or chordae elongation in degenerative diseases. The extent of the…
Type II posterior leaflet dysfunction is the most frequent dysfunction in mitral valve regurgitation caused by degenerative valvular disease. It can also be encountered in other etiologies such as bacterial endocarditis, and even rheumatic valvular disease in young children. The…