Cut-and-Transfer Technique for Ischemic Mitral Regurgitation and Severe Tethering of Mitral Leaflets

Cappabianca, Giangiuseppe; Bichi, Samuele; Patrini, Davide; Pellegrino, Pasquale; Poloni, Camillo; Perlasca, E; Redaelli, Marianna; Esposito, Giampiero

doi:10.1016/j.athoracsur.2013.06.015

Cited by 13 publications

(6 citation statements)

References 28 publications

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“…Coppabianca et al 8 investigated 49 patients who had coronary surgery plus mitral valve repair using the cut-and-transfer and posterior papillary muscle relocation techniques. All the patients received a true-size, semi-rigid, complete annuloplasty ring.…”

Section: Resultsmentioning

confidence: 99%

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Are adjunct subvalvular techniques more effective than isolated restrictive annuloplasty for treating ischemic mitral regurgitation?

Athanasopoulos

Moscarelli²,

Saglio

et al. 2016

Perfusion

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This review focused on whether subvalvular techniques are more effective than isolated restrictive annuloplasty in addressing ischemic mitral regurgitation (MR). Searching identified 445 papers and, following a selection process, we ended up with 10 articles. Two were propensity-matched studies, four retrospective and four prospective, non-randomized studies. The end points of interest were late recurrence of MR, other early echocardiographic outcomes of mitral function and early mortality. All studies focusing on echocardiographic measurements showed improved results in the groups where subvalvular repair techniques were used. In almost all studies, the recurrence of MR postoperatively was less when subvalvular techniques were used. No difference in early or in-hospital mortality was demonstrated in all four studies that included comparisons. We conclude that subvalvular techniques in combination with annuloplasty are safe and may better address ischemic MR than the use of annuloplasty ring alone.

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Section: Resultsmentioning

confidence: 99%

“…4,6 Chordal cutting, on the other hand, will mobilize a restricted anterior leaflet and decrease the tenting area and, finally, the cut-and-transfer technique will have an effect on decreasing the coaptation depth. 3,8…”

Section: Discussionmentioning

confidence: 99%

Are adjunct subvalvular techniques more effective than isolated restrictive annuloplasty for treating ischemic mitral regurgitation?

Athanasopoulos

Moscarelli²,

Saglio

et al. 2016

Perfusion

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“…Other sub-annular technique such as papillary muscle relocation could be used to relief thetering (Figure 5). 33 Echocardiography-based three-dimensional reconstructions of the mitral leaflets provided new insight into the mechanisms of functional MR, in particular by demonstrating the capacity of adaptation of the mitral leaflets, which can actively reshape in response to mechanical stretch, therefore compensating for LV dilatation. This compensatory remodeling can explain at least in part why some people have variable severity of MR despite similar degree of LV remodeling.…”

Section: Mitral Leafletsmentioning

confidence: 99%

Functional anatomy and echocardiographic assessment in secondary mitral regurgitation

Nogara

Minacapelli

Zambelli

et al. 2022

Journal of Cardiac Surgery

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Background: Mitral valve apparatus is complex and involves the mitral annulus, the leaflets, the chordae tendinae, the papillary muscles as well as the left atrial and ventricular myocardium. Secondary mitral regurgitation is a consequence of regional or global left ventricle remodeling due to an acute myocardial infarction (75% of cases) or idiopathic dilated cardiomyopathy (25% of cases). It is associated with an increase in mortality and poor outcome. There is a potential survival benefit deriving from the reduction in the degree of severity of mitral regurgitation. So the correction of the valve defect can change the clinical course and prognosis of the patient. The rationale for mitral valve treatment depends on the mitral regurgitation mechanism.Therefore, it is essential to identify and understand the pathophysiology of mitral valve regurgitation. Aim of the Study:The aim of this review is to describe the crucial role of transthoracic and trans-esophageal echocardiography, in particular with threedimensional echocardiography, for the assessment of the severity of secondary mitral regurgitation, anatomy, and hemodynamic changes in the left ventricle.Moreover, the concept that the mitral valve has no organic lesions has been abandoned. The echocardiography must allow a complete anatomical and functional evaluation of each component of the mitral valve complex, also useful to the surgeon in choosing the best surgical approach to repair the valve.Conclusions: Echocardiography is the first-line imaging modality for a better selection of patients, according to geometrical modifications of mitral apparatus and left ventricle viability, especially in preoperative phase.

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“…Moreover, and in order to enhance the results of surgical MV repair, additional interventions to the standard mitral valve annuloplasty have been developed in the last decade and provide promising results regarding outcomes in patients with secondary MR. The PM relocation procedures, such as sling procedure and PM approximation, chordae cutting or chordae "Cut-and-transfer" technique have been used with good results regarding recurrent rate of MR, positive LV remodeling, improvement of quality of life and symptomatic status (70)(71)(72)(73)(74)(75)(76)(77)(78)(79)(80)(81)(82). Other approaches directly addressing the ventricular problem and thus focused on LV wall remodeling have also been experimentally tested but without translation to patient care (83)(84)(85).…”

Section: Therapeutic Strategiesmentioning

confidence: 99%

Multimodality imaging assessment of mitral valve anatomy in planning for mitral valve repair in secondary mitral regurgitation

et al. 2017

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Secondary mitral regurgitation (MR) is frequent valvular heart disease and conveys worse prognostic. Therapeutic surgical or percutaneous options are available in the context of severe symptomatic secondary MR, but the best approach to treat these patients remains unclear, given the lack of clear clinical evidence of benefit. A comprehensive evaluation of the mitral valve apparatus and the left ventricle (LV) has the ability to clearly define and characterize the disease, and thus determine the best option for the patient to improve its clinical outcomes, as well as quality of life and symptoms. The current report reviews the mitral valve (MV) anatomy, the underlying mechanisms associated with secondary MR, the related therapeutic options available, and finally the usefulness of a multimodality imaging approach for the planning of surgical or percutaneous mitral valve intervention.

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Cut-and-Transfer Technique for Ischemic Mitral Regurgitation and Severe Tethering of Mitral Leaflets

Cited by 13 publications

References 28 publications

Are adjunct subvalvular techniques more effective than isolated restrictive annuloplasty for treating ischemic mitral regurgitation?

Are adjunct subvalvular techniques more effective than isolated restrictive annuloplasty for treating ischemic mitral regurgitation?

Functional anatomy and echocardiographic assessment in secondary mitral regurgitation

Multimodality imaging assessment of mitral valve anatomy in planning for mitral valve repair in secondary mitral regurgitation

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