A Mitral Valve Replacement With a Patch to the Posterior Calcified Annulus Demonstrated on a Pig Heart 

In this video, Dr. Vince Gaudiani uses a pig heart to provide hints and tips on how best to perform a mitral valve replacement. He began by making an incision in the anterior leaflet taking care not to excise it. Instead, he used it to pull down the annulus so he could place the first sutures into the anterior annulus from the ventricular to the atrial side, with pledgets. In the video, Dr. Gaudiani describes how he divided the annulus into one-third anterior annulus, one-sixth in both transition zones, and then one-third posterior leaflet by P2.  

A Dacron patch was then sutured to the posterior annulus and either a Mosaic valve or the Epic Valve was used, which is especially effective in females.  

In the posterior annulus, a number-one Ethilon and a larger CT2 needle was used to place the patch on the posterior annulus with a mattress suture technique, going around a calcified bar in the posterior annulus. This provided a great “washer” effect for the ring of the valve and safely addressed the calcification.  

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