MP53. Repairing Complex Rheumatic Mitral Valve : Current Advances
Chest Disease Institute
Meung, Nonthaburi
Thailand - Contact Me
Bio Dr. Taweesak Chotivatanapong
Dr.Taweesak Chotivatanapong is now The Chairman of International Academic Institute Program and Senior Consultant at Central Chest Institute of Thailand.
He is now also serving as a Senior Consultant , Vejthani Hospital, Thailand , Bangkok, Thailand. He is a councilor member of the ASCVTS, active member of AATS.
During last several years he set up Heart Care Foundation that he serves as the President of the foundation. The main activities of this foundation are to provide operations for valvular heart patients in the long waiting list and training for young surgeons under " Train The Trainer" program throughout Thailand. Several Center Of Excellences for valve repair are now successfully established under this program.
He also serves as Chairman COE of National Cardiovascular and Thoracic Disease Ministry of Public Health. After received his training for CVT surgery in Thailand, he got his further training in Australia and USA. He is the Former President of Society of Thoracic Surgeons of Thailand.
Most of his research focused on Mitral Valve Repair , Ross operation for infective AV and especially in Rheumatic Valve Repair.
In February 2020, he was the Congress President of the 28th Annual Meeting of The Asian Society of Cardiovascular and Thoracic Surgery (ASCVTS) which was organized in Chiangmai, Thailand. It was very successful and well attended.
Update 2022
Description
Taweesak Chotivatanapong, MD , Piyawat Lerdsomboon,MD
Central Chest Institute of Thailand, Nonthaburi,
*Vejthani Hospital, Bangkok,
THAILAND.
Abstract:
Rheumatic heart disease remains a big challenge for many part of the world globally. Although valve repair for rheumatic mitral valve has been successfully done with encouraging results. However, in late stage of rheumatic disease , mitral valve often is severely affected and badly changed. A truly challenging situation for repair.
Current approach for repairing this group of valve is aimed for virtual repair of the valve. Valve analysis is the crucial step for planning and choice of surgical techniques. The goals are to restore normal systolic and diastolic dynamics. Type I mobility of valve leaflets is a MUST. Both quantity and quality of valve tissues especially anterior leaflet is of paramount concern. Pliability of mitral valve leaflets and subvalvular structure are very important for normal mitral dynamics. Leaflet peeling is an integral part of rheumatic valve repair in current era. Fenestration along with papillotomy are effective to improve collateral flow as well as pliability of subvalvular structure. Chordal repair usually can be done successfully by either chordal transfer or neochordal implantation. Tissue repair can be accomplished by autologous or bovine pericardium or synthetic material depends on surgeon preference. Calcified mitral valve poses a real challenge for valve repair. Current understanding and improvement of techniques allows surgeon to successfully tacked this problem. Choice of valve ring is last but not least step for good outcome.
Conclusion: With better understanding of mitral complex and dynamics plus improvement of surgical techniques, complex rheumatic mitral valve repair can be fixed more with encouraging results.