Mitral valve surgery in the presence of flail leaflet
Ruptured chordae tendineae may involve chordae inserting into either leaflet. The causes are diverse and include infective endocarditis, acute rheumatic carditis, Marfan’s syndrome or Barlow’s disease, and direct or blunt cardiac trauma. In a large percentage of cases there is no identifiable cause, so-called idiopathic rupture of chordae tendineae. The syndrome of acute severe mitral regurgitation due to idiopathic chordal rupture should be readily recognized clinically. All cardiologists are familiar with the presentation of a patient with recent or sudden onset of severe breathlessness due to chordal rupture. The usual findings at surgery are that one or more chordae to the posterior leaflet or to the anterior leaflet or to both leaflets are ruptured. The leaflet itself is often ballooning as well as flail. The billowing may be localized to the middle scallop of the leaflet.
KeywordsMitral Valve Infective Endocarditis Mitral Valve Repair Mitral Valve Surgery Anterior Leaflet
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