LEGEND
Figure 1 – A, preoperative measure of a C-Septum distance inferior to
25 mm. B, C-Septum distance following a successful repair via posterior
mitral leaflet resection, sliding, and ring annuloplasty. C, anterior
mitral leaflet measure. D, posterior mitral leaflet measure (i.e.,
slight underestimation: 2.72 cm is the measure of the chord whereas the
arc – “true leaflet” is indeed longer). The anterior/posterior
leaflet ratio is thus close to 1.
Figure 2. Coronary angiography. A, preoperatively, the angle between the
CX and the LAD was narrow (48°), anticipating a course of the artery far
from the mitral annulus. B, before discharge, the SVG to OM was well
functioning (not shown). The angle CX-LAD increased to 74° and the CX
itself was severely distorted (angle 110°). This was possible because
the CX was far from the mitral annulus. This patient had a previous
endocarditis, which could have caused atrial wall stiffening. From
Calafiore et al. [29], with permission.
CX: circumflex artery, LAD: left anterior descending artery, OM:
obstruse marginal artery, SVG: saphenous vein graft.