The surgical treatment of mitral insufficiency and combined mitral stenosis and insufficiency using the heart-lung machine

Valvoplasty for abnormalities of posterior (mural) cusp of the mitral valve

“…The evidence available thus suggests that conservative surgery is the best treatment for rupture of posterior chordae tendineae. No other type of valvoplasty for this lesion has achieved the reputation of the McGoon procedure, though several have been attemptedleaflet bolstering (Ellis, Brandenburg, Callahan, and Marshall, 1959), Teflon chordal replacement (Morris et al, 1964), chordal resuture and annuloplasty (Kay, Egerton, and Zubiate, 1961 ;Wooler, Nixon, Grimshaw, and Watson, 1962), and cusp excision (Hessel et al, 1966).…”

“…Annuloplasty alone is not successful for this condition (Morris et al, 1964) but is necessary as an adjunct to any alteration of the cusp, though its form may vary (Gerbode et al, 1966;Kay, Tsiji, and Redington, 1965;Kay, Magidson, and Meihaus, 1962). Plication of the ring and atrial wall in continuity offers support to the suture line on the cusp as well as the necessary reduction of size of the annulus to compensate for loss of effective cusp area.…”

Durability of Mitral Valve Repair Performed Before the Age of 5 Years

“…In 38 of these patients there were coexisting congenital cardiac defects, including ventricular sepal defect (22), functionally single ventricle (6), double-outlet right ventricle (3), atrial sepal defect (2), coarctation complex (2), transposition of the great arteries (1) and tetralogy of Fallot (1). The other 14 patients had isolated congenital MV disease with regurgitation.…”

Clinical results of commissure plication annuloplasty for mitral regurgitation in children

“…Cardiac arrest was obtained with the use of cold crystalloid cardioplegic solution. Commissure plication annuloplasty (Kay-Reed method) 5,6 was performed in all patients. When coaptation of the mitral leafl et after asymmetric annuloplasty on one side did not improve, additional annuloplasty was performed on the other side.…”