Operative Mitral and Tricuspid Valve Surgery

Introduction.- Anatomy.- Physiology.- Indications for surgery - functional classification / pathophysiology.- Imaging of the mitral and tricuspid valves.- Operative set-up - exposure and analysis.- Annular dilatation - ring annuloplasty (suture annuloplasty).- Leaflet perforation.- Posterior mitral valve prolapse - neo-chordae.- Posterior mitral valve prolapse - triangular resection.- Posterior mitral valve prolapse - quadrangular resection.- Posterior mitral valve prolapse - sliding annuloplasty.- Anterior mitral valve prolapse - neo-chordae.- Anterior mitral valve prolapse - chordal transfer.- Anterior mitral valve prolapse - chordal shortening.- Bi-leaflet prolapse - Barlow's disease.- Bi-leaflet prolapse - fibro-elastic disease.- Commissural prolaspe.- Alfieri stitch (edge-to-edge).- Annular calcification.- Ischaemic mitral regurgitation - down-sizing annuloplasty.- Ischaemic mitral regurgitation -IMR ring.- Ischaemic mitral regurgitation - papillary muscle apposition (Hvass sling).- Infective endocarditis (MV) - including peri-annular abscess.- Rheumatic MV repair.- Open mitral commissurotomy.- Mitral valve replacement with SVA preservation.- HOCM - SAM.- Chordal SAM.- Tricuspid valve repair - ring annuloplasty.- Tricuspid valve repair - reduction annuloplasty (de Vega).- Tricuspid valve repair - bicuspidisation (Kay annuloplasty).- Tricuspid valve repair - anterior leaflet augmentation (pericardial patch).- Tricuspid valve repair - Ebstein's anomaly.- Tricuspid valve replacement.- AF ablation surgery.- Minimally invasive mitral valve surgery.- Future techniques - percutaneous chordae, mitra-clip, CS devices etc.- Appendix.- Index. 

Narain Moorjani is a cardiothoracic surgeon providing the full range of cardiac surgical procedures, including coronary artery bypass grafting and aortic valve replacement. He forms part of the specialist valve group, performing complex mitral valve repair surgery, as well as surgery of the thoracic aorta. He also performs procedures to control abnormal heart rhythms, as well as minimally invasive cardiac surgery (including valve surgery through small incisions and coronary surgery without the use of the heart-lung bypass machine). He was the first surgeon to introduce minimally invasive cardiopulmonary bypass to Papworth Hospital.

Narain Moorjani came to Papworth having previously worked as a consultant cardiac surgeon at the Royal Brompton Hospital, London and Assistant Professor in Cardiothoracic Surgery in Philadelphia, USA. Prior to that, he completed a research doctorate of medicine (MD) at the University of Oxford and National Heart and Lung Institute, investigating the genes involved in the development of heart failure. His research interests are currently focussing on the genes responsible for enlargement of the thoracic aorta.