title: [Surgical treatment for functional ischemic mitral regurgitation under beating heart].
abstract: Basic mechanism of ischemic mitral regurgitation (MR) is augmented leaflet tethering because of the out ward displacement of the papillary muscle by the left ventricular dilation. In 30% of ischemic MR, subvalvular procedure is necessary to eliminate MR. We propose subvalvular procedure aiming at a comprehensive remodeling of the entire mitral complex. This remodeling procedure consists of 3 major concepts; undersized mitral annuloplasty, division and reconstruction of secondary chords, and bilateral papillary muscle relocation. Subvalvular procedure under beating heart is effective to decide the length of artificial chord or papillary muscle relocation.
authors: Department of Cardiovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
authors: Naoto
authors: N
authors: Miyagi
authors: Hirokuni
authors: H
authors: Arai
mesh_terms: D009202:Cardiomyopathies / Q000209:etiology; D002311:Cardiomyopathy, Dilated / Q000209:etiology; D006355:Heart-Lung Machine; D006801:Humans; D007511:Ischemia; D058386:Mitral Valve Annuloplasty / Q000379:methods; D008944:Mitral Valve Insufficiency / Q000601:surgery*