IMR Press / RCM / Volume 16 / Issue 3 / 10.3909/ricm0772

Reviews in Cardiovascular Medicine (RCM) is published by IMR Press from Volume 19 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with MedReviews, LLC.

Open Access Review
Targeting the Papillary Muscles in Mitral Valve Repair for Ischemic Mitral Regurgitation
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1 Columbia University Division of Cardiology at Mount Sinai Heart Institute, Miami Beach, FL
Rev. Cardiovasc. Med. 2015, 16(3), 182–188;
Published: 30 September 2015
Abstract
Ischemic mitral regurgitation due to left ventricular remodeling and leaflet tethering is associated with decreased survival, and the optimal management remains unknown. Restrictive mitral annuloplasty is the current treatment of choice, but it is associated with a 15% to 30% incidence of late recurrent mitral regurgitation, which confers a poor prognosis. A pathophysiology-guided approach to surgical repair is preferable, with a goal of alleviating leaflet tethering and restoring proper subvalvular mechanics. In patients with preoperative predictors of annuloplasty failure, combining a papillary muscle repositioning technique with conventional annuloplasty repair allows for complete geometric repair of the ventriculomitral unit.
Keywords
Ischemic mitral regurgitation
Mitral annuloplasty
Papillary muscle intervention
Subvalvular repair
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