Intraoperative assessment of the mitral valve following reconstructive procedures.

A technique facilitating intraoperative assessment of the degree of mitral insufficiency during and after mitral reconstructive procedures has been developed. A multiholed left ventricular vent catheter is advanced across the aortic valve, thereby creating aortic insufficiency, filling the left ventricle with blood at aortic perfusion pressure, and approximating the leaflets of the mitral valve in the closed position. If present, mitral insufficiency can be estimated by the size of the regurgitant jet. In addition to assessing valve function following open mitral valvotomy, the method has also been helpful in managing leaks around the prosthetic valve, in assessing the closure of cleft mitral valve leaflets associated with ostium primum atrial septal defects, in confirming the completeness of closure, and in detecting obscure ventricular septal defects.