J Heart Valve Dis
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Comparative Study
Valve-preserving aortic root reconstruction: a comparison of techniques.
Controversy exists with regard to the indications and technique for valve-preserving aortic root reconstruction. Here, the authors' clinical experience with three techniques is reported. ⋯ Aortic valve-preserving surgery is possible with a low morbidity and mortality. The authors' experience shows a high failure rate in males with a large annulus needing aortic cusp repair and undergoing the reimplantation technique.
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Although repair of the mitral valve in children with or without concomitant congenital heart defects has improved significantly, it is not always achievable. The study aim was to review a 20-year experience of mitral valve replacement (MVR) in children. ⋯ MVR is a good surgical option for a nonrepairable mitral valve in children aged over 2 years. MVR following failed AVSD repair carries a high incidence of morbidity and mortality.
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The mitral annulus shows dynamic changes in shape and size during the cardiac cycle. A smaller size in end-diastole is attributed to the sphincteric action of atrial systole, and this may be important for functional integrity of the mitral valve. However, the effect of atrial fibrillation (AF) on dynamic changes in mitral annular size in humans is not known. ⋯ It is concluded that AF blunts or eliminates the phasic changes in mitral annular size during the cardiac cycle with loss of its presystolic sphincteric action; this may have implications in the genesis and surgical correction of mitral regurgitation.