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J Thorac Cardiovasc Surg 2005;129:1173-1174
© 2005 The American Association for Thoracic Surgery

Brief Communications

Chordal cutting technique through aortotomy: A new approach to treat chronic ischemic mitral regurgitation

^a Service de Chirurgie Cardiovasculaire, CHRU de Lille, France
^b Service d’ Explorations Fonctionnelles Cardio-vasculaires, CHRU de Lille, France
^c National Heart and Lung Institute, London, United Kingdom.

Received for publication August 26, 2004; revisions received August 30, 2004; accepted for publication September 3, 2004.

^_* Address for reprints: Georges Fayad, MD, Hôpital Cardiologique, 59037 Lille Cedex, France (E-mail: g-fayad@chru-lille.fr).

The first 20% of the full text of this article appears below.

The standard treatment for functional ischemic mitral regurgitation (MR) is revascularization and reduction annuloplasty. We report the first use of a modified technique to treat ischemic MR in a human by a tenting mechanism.

Patient and methods

A 77-year-old male patient with a history of chronic ischemic cardiomyopathy caused by an inferior myocardial infarct 1 year earlier was admitted to the emergency cardiac care unit after acute left ventricular failure and pulmonary edema. Echocardiography showed a poor left ventricular ejection fraction (30%) and moderate MR in addition to dyskinesia of the lateral myocardial wall. Interestingly, MR was found to be due to a restrictive mechanism with a tenting phenomenon of the anterior mitral valve leaflet. End-diastolic and end-systolic volumes were 107 and 76 mL/m², respectively (Figure 1, A).

View larger version (50K): [in this window] [in a new window]   Figure 1. A, Preoperative 2-dimensional echocardiographic analysis. Anterior leaflet angulation at the basal chord insertion, mild bulging of the ischemic inferior wall (arrow) with apical . . . [Full Text of this Article]

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