Key result
Alfieri-stitch repair via the aortic valve succeeds in 3 frail patients with severe annular calcification.
Why the study?
In complex cases with severe mitral annulus calcification and significant mitral regurgitation or SAM, or in high-risk patients where prolonged bypass is to be avoided, optimal mitral valve repair options are limited.
Case Report (n=3)
The Alfieri-stitch repair through the aortic valve offers a rapid and effective alternative for mitral valve repair in frail patients with severe annular calcification undergoing aortic valve replacement.
May support Alfieri-stitch as quick mitral option in select high-risk AVR; leaves open need for prospective validation.
In certain complex cases, where there is severe calcification of the mitral annulus but significant mitral regurgitation or systolic anterior motion (SAM), or in high-risk cases where prolonged bypass is to be avoided, the Alfieri-stitch repair of the mitral valve may be the most appropriate option available, particularly as it can be performed quickly through the aortic valve. We describe three cases undergoing aortic valve replacement, in which this technique was successfully applied in patients in whom more conventional repair techniques or valve replacement would have been hazardous, due to annular calcification and patient frailty.
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Sherlock et al. (2011) conducted a case report in Severe calcification of the mitral annulus with significant mitral regurgitation or systolic anterior motion (n=3). Alfieri-stitch repair of the mitral valve was evaluated on Successful application of the technique. The Alfieri-stitch repair was successfully applied through the aortic valve in three frail patients with severe annular calcification undergoing aortic valve replacement.
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