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You are here: Contents > 2014 > Volume 23 Number 5 September 2014 > MITRAL VALVE DISEASE > Could Anterior Papillary Muscle Partial Necrosis Explain Early Mitral Valve Repair Failure?

Could Anterior Papillary Muscle Partial Necrosis Explain Early Mitral Valve Repair Failure?

Matteo Pozzi1, Tommaso Generali1, Roland Henaine1, Julia Mitchell1, Anais Lemaire1, Pascal Chiari2, Jacques Robin1, Jean François Obadia1

Departments of 1Cardiac Surgery and 2Anesthesiology and Intensive Care, Louis Pradel Cardiologic Hospital, Hospices Civils de Lyon, Claude Bernard University, Lyon, France

Standardized techniques of mitral valve repair (MVR) have recently witnessed the introduction of a ‘respect rather than resect’ concept, the strategy of which involves the use of artificial chordae. MVR displays several advantages over mitral valve replacement in degenerative mitral regurgitation (MR), but the risk of reoperation for MVR failure must be taken into account. Different mechanisms could be advocated as the leading cause of MVR failure; procedure-related mechanisms are usually involved in early MVR failure, while valve-related mechanisms are common in late failure. Here, the case is reported of an early failure of MVR using artificial chordae that could be explained by an

unusual procedure-related mechanism, namely anterior papillary muscle necrosis. MVR failure is a well-known complication after surgical repair of degenerative MR, but anterior papillary muscle partial necrosis might also be considered a possible mechanism of procedure-related MVR failure, especially when considering the increasing use of artificial chordae. Owing to the encouraging results obtained, mitral valve re-repair might be considered a viable solution, but must be selected after only a meticulous evaluation of the underlying mechanism of MVR failure.

The Journal of Heart Valve Disease 2014;23:598-600

Could Anterior Papillary Muscle Partial Necrosis Explain Early Mitral Valve Repair Failure?

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