PMID- 24055235
OWN - NLM
STAT- MEDLINE
DCOM- 20131230
LR  - 20160512
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 96
IP  - 5
DP  - 2013 Nov
TI  - Cut-and-transfer technique for ischemic mitral regurgitation and severe tethering 
      of mitral leaflets.
PG  - 1607-13; discussion 1613
LID - S0003-4975(13)01281-2 [pii]
LID - 10.1016/j.athoracsur.2013.06.015 [doi]
AB  - BACKGROUND: Chronic ischemic mitral regurgitation (MR) denotes abnormal function 
      of normal leaflets resulting from left ventricular enlargement. We present the 
      midterm results of a tailored mitral repair technique using a combination of the 
      following subvalvular procedures: (1) detachment and reimplantation of secondary 
      chordae on the free edge of the anterior leaflet ("cut-and-transfer" technique), 
      (2) relocation of the posterior papillary muscle (PPM) closer to the mitral 
      annulus, and (3) infarct plication on the lateral wall of the left ventricle. 
      METHODS: From 2008 to 2011, 49 patients with moderate to severe ischemic MR 
      underwent coronary surgery plus mitral valve repair using the cut-and-transfer 
      and PPM relocation techniques. All the patients received a "true-sized" semirigid 
      complete annuloplasty ring. In 20 patients, a plication of the lateral wall of 
      the left ventricle was performed to reduce the tethering of the mitral leaflets. 
      The mean number of coronary grafts per patient was 3.4 +/- 0.4. RESULTS: Hospital 
      mortality was 2%. No patient died during 1-year follow-up and New York Heart 
      Association (NYHA) class improved from 3.4 +/- 0.5 to 1.4 +/- 0.6 (p < 0.0001). The 
      1-year echocardiogram showed the following changes from baseline: mitral 
      regurgitation grade (0-4) 2.9 +/- 0.4 versus 0.2 +/- 0.4 (p < 0.0001), left 
      ventricular end-systolic volume index (mL/m(2)) 52.7 +/- 13.1 versus 48.2 +/- 10.1 (p 
      = 0.07), left ventricular end-systolic index (mL/m(2)) 92.9 +/- 16.5 versus 83.4 +/- 
      15.9 (p <0.005), and ejection fraction (%) 37.8 +/- 6.3 versus 44.2 +/- 8.1 (p < 
      0.0001). CONCLUSIONS: Both clinical and echocardiographic results show that 
      reducing the tethering of the mitral leaflets with tailored interventions on 
      subvalvular apparatus without undersizing the mitral annulus can safely and 
      effectively correct chronic ischemic MR.
CI  - Copyright (c) 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Cappabianca, Giangiuseppe
AU  - Cappabianca G
AD  - Department of Cardiac Surgery, "Humanitas Gavazzeni" Hospital, Bergamo, Italy. 
      Electronic address: giangi_cappabianca@libero.it.
FAU - Bichi, Samuele
AU  - Bichi S
FAU - Patrini, Davide
AU  - Patrini D
FAU - Pellegrino, Pasquale
AU  - Pellegrino P
FAU - Poloni, Camillo
AU  - Poloni C
FAU - Perlasca, Elena
AU  - Perlasca E
FAU - Redaelli, Marianna
AU  - Redaelli M
FAU - Esposito, Giampiero
AU  - Esposito G
LA  - eng
PT  - Journal Article
DEP - 20130920
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
CIN - Ann Thorac Surg. 2016 Feb;101(2):827-8. PMID: 26777950
CIN - Ann Thorac Surg. 2016 Feb;101(2):828. PMID: 26777953
MH  - Cardiac Surgical Procedures/methods
MH  - Chordae Tendineae/surgery
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/complications/pathology/*surgery
MH  - Myocardial Ischemia/complications
MH  - Papillary Muscles/surgery
MH  - Retrospective Studies
MH  - Severity of Illness Index
OTO - NOTNLM
OT  - 35
EDAT- 2013/09/24 06:00
MHDA- 2014/01/01 06:00
CRDT- 2013/09/24 06:00
PHST- 2013/01/30 00:00 [received]
PHST- 2013/05/27 00:00 [revised]
PHST- 2013/06/03 00:00 [accepted]
PHST- 2013/09/24 06:00 [entrez]
PHST- 2013/09/24 06:00 [pubmed]
PHST- 2014/01/01 06:00 [medline]
AID - S0003-4975(13)01281-2 [pii]
AID - 10.1016/j.athoracsur.2013.06.015 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2013 Nov;96(5):1607-13; discussion 1613. doi: 
      10.1016/j.athoracsur.2013.06.015. Epub 2013 Sep 20.