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Thorac Cardiovasc Surg 2016; 64(05): 447-449
DOI: 10.1055/s-0035-1549264
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Georg Thieme Verlag KG Stuttgart · New York

Ring-Noose-String Technique Allows Adjustable Papillary Muscle Repositioning During Minimally Invasive Mitral Valve Repair in Patients with Functional/Ischemic Mitral Regurgitation

Wolfgang Bothe
1   Department of Cardiovascular Surgery, Heart Center Freiburg, Bad Krozingen, Freiburg, Germany
2   Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany
,
Torsten Doenst
2   Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany
› Author Affiliations
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Publication History

24 November 2014

12 January 2015

Publication Date:
13 April 2015 (online)

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Abstract

In patients with functional/ischemic mitral regurgitation (FMR/IMR), mitral annuloplasty alone frequently results in recurrent regurgitation because of ongoing left ventricular dilatation and recurrent leaflet tethering. Adjunctive subvalvular approaches exist, but the technical shortcomings limit their clinical acceptance. A novel adjunctive technique was applied in three patients: A polytetrafluoroethylene string and noose were anchored to the posteromedial and anterolateral papillary muscle, respectively. The string ends were guided through the noose, exteriorized through the midposterior annulus into the left atrium, and length-adjusted during the saline test. The procedure allowed safe and straightforward papillary muscle repositioning and may stabilize repair results in FMR/IMR patients.

Keywords

mitral valve surgery - heart failure - minimally invasive surgery
 

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