Original papillary muscle sandwich plasty for ischemic mitral regurgitation.
BACKGROUND
Mitral valve plasty for functional ischemic mitral regurgitation (MR) is still a controversial procedure.


RESULTS
The present study was a review of 23 patients who underwent an original technique known as "papillary muscle sandwich plasty" in which the mitral valve is approached via either the left atrium or left ventricle. The heads of the papillary muscles of the anterior leaflet and leaflets are plicated using Teflon-pledgeted 3-0 Ticron sutures in both the anterolateral and posteromedial commissural portions. Postoperative residual mild MR occurred in 1 patient (4%), but moderate or severe MR was not observed. In the follow-up study, prominent MR occurred in 1 patients and the MR-free rate at 2 years after surgery was 93%. Late cardiac death was significantly (P<0.05) fewer in patients without prominent MR than that in patients with MR.


CONCLUSIONS
"Sandwich plasty" is an effective technique for patients requiring left ventricular plasty and may improve the prognosis of ischemic heart failure.
Ishikawa
Susumu
S
Cardiovascular Division, Department of Surgery, Teikyo University School of Medicine, Kaga, Tokyo, Japan. ishikawa@med.teikyo-u.ac.jp
Ueda
Keisuke
K
Kawasaki
Akio
A
Neya
Kazuo
K
Abe
Keiko
K
Suzuki
Haruo
H
Kugawa
Satoshi
S
D000368:Aged; D000369:Aged, 80 and over; D013504:Cardiovascular Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000601:surgery; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000601:surgery*; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000601:surgery*; D009206:Myocardium; D011379:Prognosis; D016896:Treatment Outcome