How to do itRepair of Aortic Leaflet Prolapse: The “Sliding Leaflet Technique”
Section snippets
Technique
Transesophageal echocardiography is routinely employed to intraoperatively analyze aortic valve anatomy and function. The heart is approached through a median sternotomy or ministernotomy [3]. Normothermic cardiopulmonary bypass is established between the right atrium and the distal ascending aorta. The aorta is cross-clamped, and a left ventricular vent is inserted thought the superior right pulmonary vein. A transverse aortotomy is then performed, and cold blood cardioplegia is administered
Comment
The morphologic characteristics and the function of the aortic valve are interrelated to the aortic root that connects the left ventricle with the ascending aorta 4, 5. This complex structure has four anatomic components: the aortoventricular junction (or aortic annulus), leaflets, sinuses of Valsalva, and sinotubular junction. The aortic root is attached to contractile as well as fibrous components of the left ventricle. During systole, the interventricular septum shortens and moves inward,
Acknowledgements
We gratefully acknowledge the contribution of Arnaud Lacroix from Genzyme Biosurgery for the help in the preparation of the illustrations.
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