1. The ‘Down-Under Repair’ for Ischaemic Mitral Regurgitation
- Author
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David L. Prior, Alexander Rosalion, Siew Goh, Philip Davis, Ian Nixon, Michael Yii, and Andrew Newcomb
- Subjects
Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Mitral Valve Annuloplasty ,Myocardial Ischemia ,Internal medicine ,Mitral valve annuloplasty ,medicine ,Humans ,cardiovascular diseases ,Myocardial infarction ,Mitral annulus ,Papillary muscle ,Aged ,Retrospective Studies ,Mitral regurgitation ,business.industry ,Mitral Valve Insufficiency ,Mitral leaflet ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Left Ventricular Aneurysm ,Mitral incompetence ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Current surgical management of restrictive ischaemic mitral regurgitation (IMR) includes mitral valve annuloplasty (MVA) using an undersized ring when the mechanism is secondary to leaflet restriction. In our experience, MVA alone is inadequate to eliminate mitral incompetence in these patients. We report the 'Down-Under Repair' as an adjunctive concept for the treatment of a subset of patients with restrictive IMR and associated inferobasal left ventricular aneurysm. The 'Down-Under Repair' reduces mitral leaflet restriction by approximating the origin of the posterior papillary muscle towards the mitral annulus. Midterm results demonstrated sustained valvular competence and symptomatic improvement.
- Published
- 2014
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