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Papillary muscle repair surgery in ischemic mitral valve patients

R Fasol1, F Lakew, B Pfannmüller

  • 1Herz-und Gefaess-Klinik, Bad Neustadt, Germany. rfasol@heart-surgeon.com

The Annals of Thoracic Surgery
|October 4, 2000
PubMed
Abstract

Insights

This study introduces a papillary muscle-shortening plasty for ischemic mitral regurgitation, offering a safe and effective surgical solution for high-risk patients. The procedure demonstrated excellent short-term outcomes with minimal complications.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Valve Repair
  • Mitral Valve Disease

Background:

  • Ischemic mitral regurgitation (MR) presents significant surgical challenges due to papillary muscle degeneration and elongation.
  • This pathology leads to mitral valve leaflet prolapse and severe regurgitation, increasing patient risk.

Purpose of the Study:

  • To evaluate the efficacy and safety of a novel papillary muscle-shortening plasty for treating ischemic mitral regurgitation.
  • To assess the surgical outcomes and long-term benefits in a cohort of high-risk patients.

Main Methods:

  • A papillary muscle-shortening plasty was performed on 88 patients with degenerated, elongated papillary muscles causing MR (grades III-IV).
  • The repair involved a pericardium-reinforced PTFE suture and ring annuloplasty, combined with coronary artery bypass grafting in all cases.

Main Results:

  • The hospital mortality rate was 5.7% (5 deaths).
  • Postoperative mitral valve function was satisfactory, with 90.9% achieving no residual MR (MR 0) and 5.7% with mild MR (MR I).
  • At a mean follow-up of 18.6 months, freedom from reoperation and thromboembolic events was 100%, with all patients in NYHA functional class I or II.

Conclusions:

  • Careful assessment of papillary muscle pathology is crucial for successful mitral valve repair.
  • Papillary muscle-shortening plasty is a simple yet effective surgical technique for high-risk patients with ischemic mitral regurgitation.

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