Clinical case repair of

mitral valve tendon

cords
01220022028
Lorena Aguilera
Seventh Semester
UDES
 ANATOMY

-The mitral valve is a heart structure located between

the left atrium and the left ventricle of the heart. It is
composed of two valves or cusps that open and close to
allow blood flow in a single direction.
-The mitral valve also has tendon cords that connect the
cusps with the papillary muscles of the left ventricle.
These tendon cords prevent the cusps from reversing to
the left atrium during ventricular contraction.
-The function of the mitral valve is to prevent blood flow
backwards from the left ventricle to the left atrium
during heart contraction.
 PATIENT

59-year-old patient in surgical protocol for

replacement of mitral valve (mechanical)
reimplante papillary, is considered patient
ASA 3. It is considered suitable by the
anesthesiology service, it explains to
patient risks and possible complications
derived from anesthesia.
 PATIENT DATA
Name: Jose Leonardo Martinez
Age: 59
Weight: 72
Body surface: 1.88
Flow: 4.55
AOE: 2,18
Z0: 27.6
Partial urine: 6.0
Hemoglobin: 15.90
Glycemia: 89.00
SARS COV 2: Negative
Total cholesterol: 67
TSH: 1.40
 RISKS

● Bradycardia
● Hypotension
● Tachycardia
● Coagulopathy
● Acidosis
● Hypoglycemia
● Pneumothorax
● Pneumonia
● Nosocomial Infections
TREATMENT

Valve surgery is a type of intervention

designed to repair or replace one or more
injured heart valves, in order to reduce or
eliminate anomalies and symptoms
caused by the malfunction of the same.
 INDICATIONS

● Stenosis: thickening of the valve

tissue that causes narrowing of
the hole.
● Insufficiency: inability of the
valve to close completely
causing reflux or blood leakage.
CHECK LIST
SURGICAL TABLES
SURGICAL TABLES
PATIENT POSITION

Supine position
 SURGICAL PROCEDURE

• Count of gauze and compresses

• Incision with m #7 hb#15.
• Apprehension and electrocoagulation instruments for deep tissue incision: electrobisturi
• Sternotomy: reciprocating saw equipment with down saws
• Manual sternum separation: Farabeuf type separators.
• Hemostasis of the sternum: electrobisturi
• Hemostasis of the sternal periosteum and for hemostasis of the bone marrow: bone wax, electro
in 60.
• Fixed sternum separation: sternal protectors
• Suture silk 0 for pericardial repair
• Clamp passes threads and 1 pre-cut silk, for the venas cavas, upper and lower, and tourniquet to
repair these.
• Suture polyester 2/0 for tobacco bags in: Ascending aorta, superior vena cava and inferior vena
cava.
• Polypropylene 4/0 suture for small bags in: Aorta root
• Prepare adequate cannulas for patient perfusion
• Mb#7 hb#11 for arteriotomies and venotomies
• Pre-cut silk 1 for fixing the placed cannulas
• Mb#7 hb#11 for atrial incision, long metzembaum scissors to enlarge atria
 SURGICAL PROCEDURE

• Cushing separators, for viewing the atrial septum

• Mb#7 hb#11 for incision in the foramen and metzembaum long scissors to enlarge incision and
visualize mitral valve.
• 16mm needle 2-0 vascular polyester suture on each of the poles and respective repair
• Goretex 4 suture to repair tendon cords
• 2/0 polyester sutures with plush on the valve ring.
• aortic dyslampeus and the patient’s extracorporeal circulation outlet
• Thread demarcation steps for positioning in atrium and ventricle
• Suture and synthesis and chest tubes
• Nelaton 14 probe is inserted for chest tube aspiration
• Check of gauze and compress counts
• Surgical wire number 6 for facing tissues
• Patient healing
PROCEDURE
PROCEDURE
PROCEDURE
THANKS!