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Pino Fundarò
Marco Pocar
Andrea Moneta
Francesco Donatelli
Adalberto Grossi
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Ann Thorac Surg 2004;77:729-730
© 2004 The Society of Thoracic Surgeons

How to do it

Posterior mitral valve restoration for ischemic regurgitation

Pino Fundarò, MDa*, Marco Pocar, MD, PhDa, Andrea Moneta, MDa, Francesco Donatelli, MDa, Adalberto Grossi, MDa

a Divisione e Cattedra di Cardiochirurgia, IRCCS Ospedale Maggiore e Università degli Studi di Milano, Milan, Italy

Accepted for publication April 14, 2003.

* Address reprint requests to Dr Fundarò, Corso Vercelli, 35, 20144, Milan, Italy
e-mail: pinofundaro{at}yahoo.it

Chronic ischemic mitral regurgitation is traditionally a complex lesion to repair. Only restrictive annuloplasty has become an accepted strategy to avoid valve replacement, but results are unsatisfactory in some subgroups of patients. We describe an original technique that addresses the pathophysiologic mechanisms responsible for one of the most common subtypes of ischemic mitral regurgitation, ie, asymmetric tethering of the mitral leaflets after inferior myocardial infarction. The technique includes partial detachment of the posterior leaflet from the mitral annulus, annular plication, and posterior cusp plasty.




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