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.