A New Surgical Repair Technique for Ischemic Total Papillary Muscle Rupture Sung Kwang Lee, MD, Woon Heo, MD, Ho-Ki Min, MD, Do Kyun Kang, MD, Hee Jae.

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Presentation transcript:

A New Surgical Repair Technique for Ischemic Total Papillary Muscle Rupture Sung Kwang Lee, MD, Woon Heo, MD, Ho-Ki Min, MD, Do Kyun Kang, MD, Hee Jae Jun, MD, Youn-Ho Hwang, MD The Annals of Thoracic Surgery Volume 100, Issue 5, Pages 1891-1893 (November 2015) DOI: 10.1016/j.athoracsur.2014.12.091 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Preoperative and intraoperative images. (A) Preoperative coronary angiography revealed total occlusion of the proximal left circumflex coronary artery (closed arrow) and severe stenosis of the left anterior descending artery including the first diagonal branch (open arrow). (B) The mitral valve was prolapsed secondary to total rupture of the anterolateral papillary muscle trunk (asterisk). (C) Intraoperative transesophageal echocardiographic image with color flow mapping revealed severe regurgitation of the mitral valve with prolapsed leaflets. (D) Postoperative echocardiographic image with color flow mapping revealed trivial regurgitation of the mitral valve. The Annals of Thoracic Surgery 2015 100, 1891-1893DOI: (10.1016/j.athoracsur.2014.12.091) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Schematic diagrams of operation. (A) and (B) The disrupted anterolateral papillary muscle (PM) trunk was divided into two components: an anterior leaflet component and a posterior leaflet component. (C) and (D) After fixation with a sandwiched Teflon pledget, each component was respectively reattached to the nearest posteromedial PM head with a pledget-buttressed 4-0 polytetrafluoroethylene suture. (E) An undersized and asymmetric mitral annuloplasty was performed using a partial annuloplasty ring. The Annals of Thoracic Surgery 2015 100, 1891-1893DOI: (10.1016/j.athoracsur.2014.12.091) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions