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Updated: Nov 8, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Papillary-Ventricular Complex Tugging for Ischemic/Functional Mitral Regurgitation
Masanori Hirota1, Takanori Suezawa1, Takuya Kawabata1
1Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan.
Surgical repair of left ventricular remodeling effectively treats ischemic mitral regurgitation by correcting subvalvular geometry. This approach improves heart function and reduces regurgitation with minimal leaflet tethering.
Area of Science:
- Cardiovascular Surgery
- Cardiac Mechanics
- Interventional Cardiology
Background:
- Ischemic/functional mitral regurgitation often recurs after initial treatment.
- Restoring subvalvular geometry is crucial for preventing recurrence.
- Left ventricular (LV) remodeling plays a key role in mitral regurgitation.
Purpose of the Study:
- To evaluate a surgical approach for radical repair of LV remodeling.
- To address ischemic/functional mitral regurgitation in patients with coronary lesions.
- To assess the efficacy of correcting leaflet tethering and LV scar.
Main Methods:
- Surgical restoration of subvalvular geometry.
- Tugging of the papillary-ventricular complex to correct leaflet tethering.
- Concomitant exclusion of postinfarction scar tissue.
Main Results:
- Successful restoration of LV remodeling.
- Significant diminution of mitral regurgitation.
- Minimal residual leaflet tethering.
- Improved systolic LV function.
Conclusions:
- Surgical LV remodeling is an effective strategy for ischemic/functional mitral regurgitation.
- The technique addresses leaflet tethering and LV scar.
- This aggressive approach is encouraged for selected patients.
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