title: Could anterior papillary muscle partial necrosis explain early mitral valve repair failure?
abstract: Standardized techniques of mitral valve repair (MVR) have recently witnessed the introduction of a 'respect rather than resect' concept, the strategy of which involves the use of artificial chordae. MVR displays several advantages over mitral valve replacement in degenerative mitral regurgitation (MR), but the risk of reoperation for MVR failure must be taken into account. Different mechanisms could be advocated as the leading cause of MVR failure; procedure-related mechanisms are usually involved in early MVR failure, while valve-related mechanisms are common in late failure. Here, the case is reported of an early failure of MVR using artificial chordae that could be explained by an unusual procedure-related mechanism, namely anterior papillary muscle necrosis. MVR failure is a well-known complication after surgical repair of degenerative MR, but anterior papillary muscle partial necrosis might also be considered a possible mechanism of procedure-related MVR failure, especially when considering the increasing use of artificial chordae. Owing to the encouraging results obtained, mitral valve re-repair might be considered a viable solution, but must be selected after only a meticulous evaluation of the underlying mechanism of MVR failure.
authors: Matteo
authors: M
authors: Pozzi
authors: Tommaso
authors: T
authors: Generali
authors: Roland
authors: R
authors: Henaine
authors: Julia
authors: J
authors: Mitchell
authors: Anais
authors: A
authors: Lemaire
authors: Pascal
authors: P
authors: Chiari
authors: Jean
authors: J
authors: Fran
authors: Jean François
authors: JF
authors: Obadia
mesh_terms: D000367:Age Factors; D000368:Aged; D002815:Chordae Tendineae; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000473:pathology* / Q000601:surgery*; D009336:Necrosis / Q000150:complications; D010210:Papillary Muscles / Q000473:pathology*; D012086:Reoperation; D017211:Treatment Failure