Key result
Asymmetric A1-P1 edge-to-edge stitch resolves systolic anterior motion after mitral valve repair.
Why the study?
Systolic anterior motion after mitral valve repair is a challenging complication with difficult surgical correction that may require valve replacement.
An asymmetric modification of the Alfieri edge-to-edge technique (A1-P1 suture) may help correct systolic anterior motion after mitral valve repair without requiring valve replacement.
May allow valve preservation for post-repair SAM in select cases; leaves open need for prospective validation.
Systolic anterior motion of the mitral valve is a feared complication after valve repair, with important implications in the postoperative period. Provocation with isoproterenol is valuable in the assessment of its mechanism and severity in high-risk patients. Surgical correction of this condition is sometimes difficult and may require valve replacement. We present a modification of Alfieri's edge-to-edge technique that adapts better to the mechanism of systolic anterior motion (SAM) after mitral repair in selected patients by placing the edge-to-edge suture between the A1-P1 segments and not in the midline.
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Pereda et al. (2010) studied Systolic anterior motion after mitral valve repair. Asymmetric Alfieri's stitch (edge-to-edge suture between A1-P1 segments) was evaluated. An asymmetric modification of Alfieri's edge-to-edge technique, placing the suture between the A1-P1 segments, was presented to correct systolic anterior motion after mitral valve repair.
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