Ann Thorac Surg Short Rep. 2025 Dec 9;4(2):590-595. doi: 10.1016/j.atssr.2025.11.016. eCollection 2026 Jun.
ABSTRACT
BACKGROUND: We developed a formula to estimate the optimal distance between the posterior papillary muscle (PPM) and the midseptal fibrous annulus (D) to facilitate PPM relocation in patients with ischemic mitral regurgitation (IMR) undergoing mitral valve repair.
METHODS: D was measured in 109 patients without valvular disease undergoing electrocardiogram-gated 3-dimensional computed tomography, and a predictive formula that best approximated this value was developed. This formula was evaluated in 10 patients (59.2 [SD, 10.7] years, 7 men) with moderate-severe IMR undergoing mitral valve repair using PPM relocation by 3 surgeons in 6 institutions from 2014 to 2023. Two arms of CV-3 suture fixed at the PPM were passed through the midseptal fibrous annulus to the annuloplasty ring and tied at the length estimated using the formula (35 [SD, 4] mm).
RESULTS: Postoperative echocardiography demonstrated neither residual regurgitation nor leaflet tenting. Three patients died and 1 underwent mitral valve replacement during follow-up (71 [SD, 35] months), but IMR was well controlled, and left ventricular reverse remodeling and improved left ventricular function was observed in the other 6.
CONCLUSIONS: This formula facilitates mitral valve repair using PPM relocation in patients with IMR.
PMID:42267046 | PMC:PMC13245287 | DOI:10.1016/j.atssr.2025.11.016