Related Experiment Video
Updated: May 8, 2026

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
The 'down-under repair' for ischaemic mitral regurgitation
Siew Goh1, Andrew Newcomb1, David Prior2
1Cardiothoracic Department in affiliation with University of Melbourne, Department of Surgery, St Vincent's Hospital, Melbourne, Australia.
Abstract:
Current surgical management of restrictive ischaemic mitral regurgitation (IMR) includes mitral valve annuloplasty (MVA) using an undersized ring when the mechanism is secondary to leaflet restriction. In our experience, MVA alone is inadequate to eliminate mitral incompetence in these patients. We report the 'Down-Under Repair' as an adjunctive concept for the treatment of a subset of patients with restrictive IMR and associated inferobasal left ventricular aneurysm. The 'Down-Under Repair' reduces mitral leaflet restriction by approximating the origin of the posterior papillary muscle towards the mitral annulus. Midterm results demonstrated sustained valvular competence and symptomatic improvement.
Related Concept Videos
Mitral Regurgitation III: Medical Management
Mitral Regurgitation I: Introduction
Mitral Stenosis III: Medical Management
Mitral Regurgitation IV: Nursing Management
Mitral Regurgitation II: Clinical Features and Diagnostic Tests
Mitral Stenosis II: Clinical features and Diagnostic Tests

