Anterior Mitral Leaflet Augmentation for Ischemic Mitral Regurgitation Performed Via a Right Thoracotomy Approach

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Repair
• Minimally Invasive Cardiac Surgery

Background:

• Ischemic mitral regurgitation (MR) following myocardial infarction (MI) is linked to reduced long-term survival.
• Restrictive annuloplasty is the standard mitral valve repair, but recurrence rates range from 15% to 30% due to ventricular remodeling.
• Progressive left ventricular remodeling and geometric distortion compromise the mitral valve apparatus, leading to recurrent MR.

Observation:

• This study presents two cases of severe ischemic MR treated with anterior mitral leaflet augmentation and annuloplasty.
• The procedure was performed using a minimally invasive right thoracotomy approach.
• Literature on patient selection and clinical outcomes for this adjunctive technique was reviewed.

Findings:

• Anterior mitral leaflet augmentation, combined with true-sized annuloplasty, enhances the durability of mitral valve repair for ischemic MR.
• The described minimally invasive technique shows potential for treating severe ischemic MR.
• Review of existing literature supports the efficacy of this combined approach.

Implications:

• Anterior mitral leaflet augmentation may offer a more durable solution for ischemic MR, potentially improving long-term outcomes.
• Minimally invasive approaches for mitral valve repair can reduce patient recovery time and morbidity.
• Further research into patient selection and long-term results is warranted to establish this technique as a standard of care.