Abstract
The edge-to-edge (EE) repair, also known as “Alfieri’s stitch” is a reproducible and effective technique to restore mitral valve (MV) competence. When this technique is applied in the central part of the anterior and posterior MV leaflets, two orifices are created and the effective MV area is significantly reduced.3D-computational models and in vitro studies have demonstrated that the hemodynamic performance of a double orifice valve is similar to that of a single orifice one with the same total effective orifice area.Clinical experience and sperimental dataassess that functional MS doesn’t exist. It can be possible to have an anatomical post surgical MS and according to computational models it is important to mantain a residual area larger than 2.5 cm2 in normal size patient.Major risk factors of post EE repair MS are: small native area, large intercommissural width of lesion and extention of surgical suture, restrictiveannuloplasty.All the standard echocardiographic parameters and derived calculation for the assessment of significantMS, described in literature, have some limitations expecially in the intraoperative setting, in wich it is very important to assess the 2D planimetric or 3Dtotal area of the two orefice.The use 3D echocardiography assessment of the double orefice area is becoming the gold standard for the evaluation of possible post surgical repair MS.
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Di Giannuario, G., La Canna, G. (2015). Mitral Stenosis After Edge-to-Edge Repair: Is It an Issue?. In: Alfieri, O., De Bonis, M., La Canna, G. (eds) Edge-to-Edge Mitral Repair. Springer, Cham. https://doi.org/10.1007/978-3-319-19893-4_9
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DOI: https://doi.org/10.1007/978-3-319-19893-4_9
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