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Updated: May 27, 2026

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
[Surgical treatment for functional ischemic mitral regurgitation under beating heart]
1Department of Cardiovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Abstract:
Basic mechanism of ischemic mitral regurgitation (MR) is augmented leaflet tethering because of the out ward displacement of the papillary muscle by the left ventricular dilation. In 30% of ischemic MR, subvalvular procedure is necessary to eliminate MR. We propose subvalvular procedure aiming at a comprehensive remodeling of the entire mitral complex. This remodeling procedure consists of 3 major concepts; undersized mitral annuloplasty, division and reconstruction of secondary chords, and bilateral papillary muscle relocation. Subvalvular procedure under beating heart is effective to decide the length of artificial chord or papillary muscle relocation.
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