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Ann Thorac Surg 2006;81:2324-2325
© 2006 The Society of Thoracic Surgeons

How to do it

New Surgical Approach to Reduce Tethering in Ischemic Mitral Regurgitation by Relocation of Separate Heads of the Posterior Papillary Muscle

Tetsuya Ueno, MD a , * , Ryuzo Sakata, MD a , Yoshifumi Iguro, MD a , Toshiyuki Nagata, MD a , Yutaka Otsuji, MD b , Chuwa Tei, MD b

a Department of Thoracic and Cardiovascular Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Kagoshima, Japan
b Department of Cardiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Kagoshima, Japan

Accepted for publication March 16, 2005.

* Address correspondence to Dr Ueno, Department of Thoracic and Cardiovascular Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520 Japan (Email: tueno{at}m.kufm.kagoshima-u.ac.jp).

The surgical treatment of chronic ischemic mitral regurgitation remains a challenging issue. Several procedures have been developed to correct displacement of the papillary-ventricular complex and to reduce tethering-induced regurgitation. We report a geometric approach to relocate the laterally displaced posterior papillary muscle towards the mitral annulus. This procedure is believed to be technically easy and useful, especially in cases in which the displaced posterior papillary muscle contributes to tethering-induced regurgitation.




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