Papillary muscle sandwich plasty for the treatment of functional mitral valve regurgitation.
We evaluated the availability of original "sandwich plasty" for the treatment of functional mitral regurgitation (FMR) associated with ischemic heart disease (IHD) and aortic valve disease (AVD). Forty-three patients were reviewed, including 27 IHD patients and 16 AVD patients. Preoperatively severe FMR was detected in 14 patients, moderate FMR in 26, and mild FMR in 3. The papillary muscle heads of anterior leaflets and posterior leaflets were approximated using Teflon-pledgeted 3-0 Ticron sutures at anterolateral and posteromedial commissural portions. After surgery, residual moderate FMR was observed in 1 patient and mild FMR in 3 patients. Tenting height of the mitral valve significantly decreased. FMR free rates 2 years after surgery were 93% among IHD patients and 83% in AVD patients. "Sandwich plasty" was simple and effective for the treatment of functional FMR caused by tethering effects due to left ventricular dilatation.
Department of Cardiovascular Surgery, Teikyo University School of Medicine, Tokyo, Japan. susumuishikawa@hotmail.co.jp
Susumu
S
Ishikawa
Keisuke
K
Ueda
Kazuo
K
Neya
Akio
A
Kawasaki
Akihito
A
Kakinuma
Hidetoshi
H
Sakamoto
Koji
K
Kuwana
Hirokazu
H
Nagatani
Hiroshi
H
Otake
Shigeho
S
Morita
D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000150:complications; D001024:Aortic Valve Stenosis / Q000150:complications; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery*; D017202:Myocardial Ischemia / Q000150:complications; D010210:Papillary Muscles / Q000601:surgery*; D016896:Treatment Outcome