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Thorac Cardiovasc Surg · Aug 2016
Ring-Noose-String Technique Allows Adjustable Papillary Muscle Repositioning During Minimally Invasive Mitral Valve Repair in Patients with Functional/Ischemic Mitral Regurgitation.
- Wolfgang Bothe and Torsten Doenst.
- Department of Cardiovascular Surgery, Heart Center Freiburg, Bad Krozingen, Freiburg, Germany.
- Thorac Cardiovasc Surg. 2016 Aug 1; 64 (5): 447-9.
AbstractIn 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. Georg Thieme Verlag KG Stuttgart · New York.
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