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European Heart Journal Advance Access originally published online on June 2, 2006
European Heart Journal 2006 27(24):2918; doi:10.1093/eurheartj/ehl052
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

‘Edge-to-edge’ mitral valve repair: the ace of hearts

Valerio Zacà1,*, Elisa Giacomin1, Mario Chiavarelli2 and Sergio Mondillo1

1 Department of Cardiology, University of Siena, Viale Bracci 1, 53100 Siena, Italy
2 Department of Cardiothoracic Surgery, University of Siena, Viale Bracci 1, 53100 Siena, Italy

* Corresponding author. Tel: +39 0577 585379; fax: +39 0577 233112. E-mail address: valezeta{at}libero.it

A 32-year-old man underwent a successful surgical correction of a severe mitral regurgitation. The surgical procedure consisted of an ‘edge-to-edge’ repair of the valve, connecting the mid-portion of the anterior and posterior leaflets, associated with implantation of a mitral annuloplasty ring (Sovering Ø 38 mm; Sorin Biomedica Cardio). The ‘edge-to-edge’ or double orifice Alfieri technique represents an option in mitral valve repair surgery. Transthoracic echocardiography is routinely performed for follow-up monitoring of these patients; common echocardiographic features are a double mitral orifice (‘eight-shaped figure’) and two separated transmitral jets in diastole.

Post-operative transthoracic echocardiography in our patient showed a good functioning double-orifice mitral valve (asterisks) with a central dense echogenic area (solid white arrow) corresponding to the repair site (Panel A) (see also Supplementary movie available at European Heart Journal online). A further characterization of the region of Alfieri repair (blank white arrow) was obtained from the apical four-chamber view (Panels B and C). Interestingly, in colour Doppler analysis, the two transmitral jets originating from the valve plane converged in the apical portion of the left ventricle depicting the shape of a playing card ace of hearts (Panel D).

Panel A. Parasternal short-axis view.

Panels B and C. LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle.

Panel D. Same apical four-chamber view as in Panel C.

Formula


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This Article
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Right arrow All Versions of this Article:
27/24/2918    most recent
ehl052v1
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