title: A case report of surgical correction for congenital mitral regurgitation with subvalvular apparatus abnormality.
abstract: We report a successful complex mitral valve plasty using port access minimally invasive cardiac surgery for congenital mitral regurgitation that presented as an abnormality of the subvalvular apparatus. A 16-year-old male patient received a diagnosis of mitral regurgitation resulting from tethering of the anterior mitral leaflet and posterior mitral leaflet caused by an abnormality in papillary muscle insertion and a hypoplastic chordae tendineae. The posterior leaflet was closely tethered to the tips of the papillary muscle with essentially no chordae tendineae. The flexibility of the leaflet was restored by surgically removing the abnormal chordae, and reconstruction of chordae tendinae of the anterior leaflet was carried out using three loops and of the posterior leaflet using one loop with a loop technique method. As an additional procedure for persistent regurgitation, an edge-to-edge technique to the posterior commissure side was performed, after which the mitral regurgitation disappeared.
authors.affiliation: Department of Surgery, School of Medicine, Keio University, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan. m-kudo@sc.itc.keio.ac.jp
authors.forename: Mikihiko
authors.initials: M
authors.lastname: Kudo
authors.forename: Ryohei
authors.initials: R
authors.lastname: Yozu
authors.forename: Ryo
authors.initials: R
authors.lastname: Aeba
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Kokaji
authors.forename: Naritaka
authors.initials: N
authors.lastname: Kimura
authors.forename: Shiro
authors.initials: S
authors.lastname: Iwanaga
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures; D002815:Chordae Tendineae / Q000002:abnormalities / Q000601:surgery*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D008943:Mitral Valve / Q000002:abnormalities / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D010210:Papillary Muscles / Q000002:abnormalities / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography