Chordal “translocation” for functional mitral regurgitation with severe valve tenting: An effort to preserve left ventricular structure and function

Fukuoka, Masatsune; Nonaka, Michihito; Masuyama, Shinji; Shimamoto, Takeshi; Tambara, Keiichi; Yoshida, Hajime; Ikeda, Tadashi; Komeda, Masashi

doi:10.1016/j.jtcvs.2006.10.063

Cited by 17 publications

(8 citation statements)

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“…The etiology of ischemic MR is complicated because it results from a variable combination of annular dilatation and remodeling of the subvalvular apparatus. Various techniques such as annuloplasty, 2 edgeto-edge technique 3 and chordal cutting 4,5 of the mitral valve have been reported, but although the annular dilatation may be effectively treated, methods for addressing the subvalvular remodeling have not been standardized.…”

Section: Discussionmentioning

confidence: 99%

Original Papillary Muscle Sandwich Plasty for Ischemic Mitral Regurgitation

Ishikawa

Ueda

Kawasaki

et al. 2009

Circ J

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hronic ischemic mitral regurgitation (MR) is a cause of congestive heart failure in patients with ischemic cardiomyopathy. Various mitral valve plasty (MVP) techniques have been reported, but the best surgical intervention is still controversial and the development of new techniques is necessary to give better outcome for patients with ischemic MR. We initiated our original procedure called "papillary muscle sandwich plasty" 1 in 2004 and in this study, we evaluated its early and late surgical results. Methods PatientsOf 602 ischemic heart disease patients, 46 underwent MVP for ischemic MR between 1999 and 2007 and of them, 23 patients since 2004 underwent papillary muscle sandwich plasty. The mean age of the patients was 67 (47-82) years and there were 16 men and 7 women. The patients' preoperative characteristics, examination results and operative procedures are summarized in Table 1.According to preoperative echocardiography, the mean left ventricle diastolic and systolic diameters were 54±6 mm and 43±7 mm, respectively. The mean mitral annulus diameter and tenting height was 29.5±2.4 mm and 12.0±2.8 mm, respectively. The grade of preoperative MR was severe in 10 patients and moderate in 13. Mitral ring-annuloplasty was performed in 9 (39%) patients and left ventricular volume reduction in 5 (22%). Postoperative early and late results were evaluated. The mean follow-up period was 24±10 months (range 7-39 months). TechniqueOur technique of "sandwich plasty" is usually performed (Received June 16, 2008; revised manuscript received January 12, 2009; accepted February 19, 2009; released online May 18, 2009 Methods and 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. (Circ J 2009; 73: 1240 -1242

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Section: Discussionmentioning

confidence: 99%

Original Papillary Muscle Sandwich Plasty for Ischemic Mitral Regurgitation

Ishikawa

Ueda

Kawasaki

et al. 2009

Circ J

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“…38,42,43 This method is in parallel with the natural structure and function of the mitral valve, but it is a slightly more complex procedure and might require some experience when conducting it, especially in order to prevent aortic regurgitation. Langer and Schäfers reported the anterior relocation of each papillary tip without cutting the secondary chodae.…”

Section: Combined Methods To Repair the Leaflet/pms/lvmentioning

confidence: 99%

“…36,37 In some reports, the method did not impair LV function, 36 while in others it did. 38 As the secondary chordate plays a role to protect LV dimen- sion and function, the chordal cutting method might impair LV function, at least under certain conditions.…”

Section: For Tethering or Abnormal Position Of Papillary Tips Or Leafmentioning

confidence: 99%

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Surgical Treatment for Functional Mitral Regurgitation

Komeda

Kitamura

Fukaya

et al. 2009

Circ J

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“…Последние экс-периментальные работы подтверждают преимущество транслокации даже при ишемической болезни сердца [50]. Последующие клинические наблюдения средне-срочных и отдаленных результатов необходимы, чтобы подтвердить пользу транслокации вторичных хорд.…”

Section: резекционные и нерезекционные технологии реконструкции мкunclassified

Clinical and Fundamental Aspects of Prosthetics and Translocation of Mitral Valve Chords

Makogonchuk¹,

Евтушенко²,

Евтушенко³

2018

Sib. med. ž. (Tomsk)

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Научно-исследовательский институт кардиологии, Томский национальный исследовательский медицинский центр Российской академии наук, 634012, Российская Федерация, Томск, ул. Киевская, 111аCardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 111а, Kievskaya str., Тоmsk, 634012, Russian Federation В данной статье приводится обзор современных методик лечения пролапса митрального клапана вследствие деге-нерации. Медикаментозное лечение пациентов с пролапсом митрального клапана малоэффективно. Предпочтение в данном случае следует отдать хирургическому лечению. Показано, что при выборе тактики вмешательства важно учитывать не только наличие самой патологии, но и исходное функциональное состояние элементов подклапан-ного аппарата. Так, среди методов хирургического лечения протезирование клапана при данной патологии имеет значительные недостатки по сравнению с реконструктивной хирургией. Показано разнообразие техник пластики митрального клапана. Представлены преимущества и недостатки каждого из методов. Ключевые слова: хирургическое лечение пролапса митрального клапана, разнообразие техник пластики ми-трального клапана Конфликт интересов: авторы заявляют об отсутствии конфликта интересов Прозрачность финансовой деятельности: никто из авторов не имеет финансовой заинтересованности в представленных материалах или методах Для цитирования: Макогончук И. С., Евтушенко В. В., Евтушенко А. В. Клинические и фундаментальные аспекты протезирования и транслокации хорд митрального клапана. Сибирский медицинский журнал. 2018; 33(1): 27-32. DOI: 10.29001/2073DOI: 10.29001/ -8552-2018 This article provides an overview of modern methods of treating prolapse of the mitral valve due to degeneration. Medical treatment of patients with mitral valve prolapse is ineffective. Preference in this case should be given to the surgical treatment. It is shown that while choosing tactics of intervention it is important to take into account not only the presence of the pathology itself, but also the initial functional state of the elements of the subvalvular apparatus. So, among the methods of surgical treatment, valve prosthesis in this pathology has significant disadvantages in comparison with reconstructive surgery. A variety of techniques for mitral valve plastic are shown. The advantages and disadvantages of each method are presented. Keywords: surgical treatment of mitral valve prolapse, a variety of mitral valve plastic techniques Conflict of interest: the authors do not declare a conflict of interest Financial disclosure: no author has a financial or property interest in any material or method mentioned Недостаточность митрального клапана (МК) -наи-более распространенный порок сердца в Европе [1], зо-лотым стандартом коррекции которого признана много-компонентная реконструкция клапана [2]. Важнейший компонент подобных операций -коррекция длины хорд клапана, наиболее распространенными разновид-ностями которой являются протезирование хорд син-тетическими материалами и использование аутохорд и аутоство...

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Chordal “translocation” for functional mitral regurgitation with severe valve tenting: An effort to preserve left ventricular structure and function

Abstract: "Translocation" of the secondary chordae tendineae after chordal cutting improved left ventricular systolic function compared with simple chordal cutting.

Cited by 17 publications

References 19 publications

Original Papillary Muscle Sandwich Plasty for Ischemic Mitral Regurgitation

Original Papillary Muscle Sandwich Plasty for Ischemic Mitral Regurgitation

Surgical Treatment for Functional Mitral Regurgitation

Clinical and Fundamental Aspects of Prosthetics and Translocation of Mitral Valve Chords

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