Why the study?
Does papillary muscle sandwich plasty reduce functional mitral regurgitation in patients with ischemic heart disease or aortic valve disease?
Does papillary muscle sandwich plasty reduce functional mitral regurgitation in patients with ischemic heart disease or aortic valve disease?
Papillary muscle sandwich plasty is a simple and effective surgical technique for treating functional mitral regurgitation caused by left ventricular dilatation.
May support papillary muscle sandwich plasty for FMR in IHD/AVD; leaves open need for randomized confirmation.
We evaluated the availability of original "sandwich plasty" for the treatment of functional mitral regurgitation (FMR) associated with ischemic heart disease (IHD) and aortic valve disease (AVD). Forty-three patients were reviewed, including 27 IHD patients and 16 AVD patients. Preoperatively severe FMR was detected in 14 patients, moderate FMR in 26, and mild FMR in 3. The papillary muscle heads of anterior leaflets and posterior leaflets were approximated using Teflon-pledgeted 3-0 Ticron sutures at anterolateral and posteromedial commissural portions. After surgery, residual moderate FMR was observed in 1 patient and mild FMR in 3 patients. Tenting height of the mitral valve significantly decreased. FMR free rates 2 years after surgery were 93% among IHD patients and 83% in AVD patients. "Sandwich plasty" was simple and effective for the treatment of functional FMR caused by tethering effects due to left ventricular dilatation.
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Ishikawa et al. (2011) studied this question.
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