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A New Clamp for Mitral Valve Excision
A New Clamp for Mitral Valve Excision Bruce C. Paton, M.B.,M.R.C.P., F.R.C.S.
T
e left-sided approach is used by many surgeons for excision and replacement of the mitral valve. This gives excellent exposure and makes the valve readily accessible. By this approach, however, the aortic leaflet of the mitral valve is presented to the operator as a flat surface hanging almost vertically from the upper part of the valve ring. Excision of the valve can be effected by two methods, either by first dividing the chordae at their origin from the papillary muscles, or by
FIG. 1. Bronchus clamp modified for grasping mitral valve cusps.
first incising the valve along a line following the annulus. If the valve is to be excised by first dividing the chordae and then turning the cusp upward, the usual types of clamp are often inconvenient for grasping the free edge of the cusp. In the usual type of angled clamp, the plane of the angled tip is at a right angle to the plane of opening of the handles and the plane of opening of the points is at a right angle to From the Halsted Laboratory for Experimental Surgery, Department of Surgery, University of Colorado Medical Center, Denver, Colo. Accepted for publication Aug. 13, 1965.
VOL. 2, NO. 1 , JAN.,
1966
log
PATON
any flat surface; such a clamp has to be awkwardly handled if it is to grasp the free edge of the cusp. A more convenient clamp for this purpose (Fig. 1) has been designed from a modified bronchus clamp." T h e plane of both the angulation and the direction of opening of the jaws is parallel to the plane of action of the handles. In this way, the free edge of a cusp can be easily grasped. Because the valves for excision are toughly fibrosed or heavily calcified, a strong, toothed jaw has been provided for good gripping of the cusp, and the jaws open sufficiently to grasp even the most heavily calcified cusp with ease.
*Available from Miltex Instrument Co., Division of Miltenberg, Inc., 43 Gt. Jones St., New York 12, N.Y.
110
THE ANNALS OF THORACIC SURGERY
T
e left-sided approach is used by many surgeons for excision and replacement of the mitral valve. This gives excellent exposure and makes the valve readily accessible. By this approach, however, the aortic leaflet of the mitral valve is presented to the operator as a flat surface hanging almost vertically from the upper part of the valve ring. Excision of the valve can be effected by two methods, either by first dividing the chordae at their origin from the papillary muscles, or by
FIG. 1. Bronchus clamp modified for grasping mitral valve cusps.
first incising the valve along a line following the annulus. If the valve is to be excised by first dividing the chordae and then turning the cusp upward, the usual types of clamp are often inconvenient for grasping the free edge of the cusp. In the usual type of angled clamp, the plane of the angled tip is at a right angle to the plane of opening of the handles and the plane of opening of the points is at a right angle to From the Halsted Laboratory for Experimental Surgery, Department of Surgery, University of Colorado Medical Center, Denver, Colo. Accepted for publication Aug. 13, 1965.
VOL. 2, NO. 1 , JAN.,
1966
log
PATON
any flat surface; such a clamp has to be awkwardly handled if it is to grasp the free edge of the cusp. A more convenient clamp for this purpose (Fig. 1) has been designed from a modified bronchus clamp." T h e plane of both the angulation and the direction of opening of the jaws is parallel to the plane of action of the handles. In this way, the free edge of a cusp can be easily grasped. Because the valves for excision are toughly fibrosed or heavily calcified, a strong, toothed jaw has been provided for good gripping of the cusp, and the jaws open sufficiently to grasp even the most heavily calcified cusp with ease.
*Available from Miltex Instrument Co., Division of Miltenberg, Inc., 43 Gt. Jones St., New York 12, N.Y.
110
THE ANNALS OF THORACIC SURGERY