Abstract
In patients with functional/ischemic mitral regurgitation (FMR/IMR), mitral annuloplasty
alone frequently results in recurrent regurgitation because of ongoing left ventricular
dilatation and recurrent leaflet tethering. Adjunctive subvalvular approaches exist,
but the technical shortcomings limit their clinical acceptance. A novel adjunctive
technique was applied in three patients: A polytetrafluoroethylene string and noose
were anchored to the posteromedial and anterolateral papillary muscle, respectively.
The string ends were guided through the noose, exteriorized through the midposterior
annulus into the left atrium, and length-adjusted during the saline test. The procedure
allowed safe and straightforward papillary muscle repositioning and may stabilize
repair results in FMR/IMR patients.
Keywords
mitral valve surgery - heart failure - minimally invasive surgery
