[HSF] small mitral valve

[Hgrmd at aol.com]

Hi Peter,
  Nice to see you add your insight to this problem.  One thing I  forgot to 
mention is to consider using a 24mm ATS AP valve.  I've  successfully used this 
a couple of times in this situation.  It's analogous  to the aortic top hat.  
The sewing ring sits on top, not inside the mitral  orifice.  You have to 
make sure the sutures are a little more close  together than usual, since the 
sewing ring doesn't lie within the confines of  the annulus. Both times, I used 
it in small ladies.  They made uneventful  recoveries with no significant 
gradient on TEE.  
 
Hal