There was a structural gap between the tricuspid leaflet indentations and the subvalvular structures. The relationships among the leaflets, commissures, and subvalvular structures differed in the septal, anterior, and posterior leaflets. This new definition of the commissural point may aid the development of a clear-cut methodology for prosthetic ring annuloplasty.

Triangular resection of a prolapsed anterior leaflet of the mitral valve provides durable and reliable long-term results.

Cardiac malformations associated with the syndrome of atriovisceral heterotaxy are among the most complex forms of congenital heart disease. Accordingly, the disposition of the specialized conduction tissue (the conduction system) is also variable and complex in these particular anomalies. The location of the conduction system and the degree of abnormalities of the conduction system correlate with the severity and location of the associated structural cardiac anomalies.

No abstract

Bland-White-Garland (BWG) syndrome is a rare congenital heart disease in which the left coronary artery originates from the pulmonary artery (PA). Surgical treatment to rebuild a dual coronary system is recommended at the time of the diagnosis. However, no effective operative procedure has been established for adult-type BWG patients because of the paucity of such cases. We herein report a case of adult-type BWG that was successfully treated by patch closure of the orifice of the left main tract from the main PA and coronary artery bypass grafting. 123 I-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) and 201 thallium (Tl) dual myocardial single-photon emission computed tomography (SPECT) were performed before surgery, early after surgery, and at three months after surgery. Before surgery, dual SPECT showed myocardial perfusion defects in the anterior and septal wall, which corresponded to the cardiovascular magnetic resonance imaging findings. Early after surgery, only 201 Tl images demonstrated an improvement in the defect area. At three months after surgery, both the 201 Tl and 123 I-BMIPP imaging findings demonstrated an improvement in the defect area, which was correlated with the recovery of the left ventricular function. These results showed the effectiveness of this surgical approach for BWG syndrome.