Assessment of mitral valve function at operation and the prevention of systemic embolism

Abstract

When assessing the function of the mitral valve at operation by palpation or inspection, the surest way to prevent systemic (cerebral) embolism is to have the ascending aorta occluded by a clamp.A technique is described which allows safe assessment of mitral valve function by aortic root and left ventricular perfusion, giving a beating-heart preparation with the aorta cross-clamped.This method has been in successful use for more than two years and has been found particularly useful in the accurate repair of cleft mitral valves in atrioventricular defects (ostium primum defects and atrioventricular canal).

Intraoperative Assessment of the Reconstructed Mitral Valve Using a Low Pressure Crystalloid Infusion

“…Consistently good results of mit ral repair depend on the experienced use of a number of techniques in order to appropriately deal with the variety of individual lesions. For this, testing the reconstructed valve under direct vision appears to be indispensable (4,19). In the past, testing the left ventricle was usually perfonned by filling the left ventricle with pump blood .…”

Mitral valve reconstruction by posterior cusp advancement using a pericardial graft. Long-term follow-up in nine patients.

“…In each case, once the repair was complete and bypass had been stopped, the valve was palpated and the result assessed. In case 9, the valve was tested under direct vision with the heart beating and the aorta clamped (Ross, 1971) before aortic valve replacement. The results of this initial assessment of the amount of residual regurgitation are shown (Table II).…”