Mitral valve repair in papillary muscle rupture

Abstract

Papillary muscle rupture (PMR) is a significant mechanical complication following myocardial infarction (MI), a condition associated with a high mortality. It results in severe mitral valve regurgitation (MR), often accompanied by cardiogenic shock and pulmonary edema, requiring both emergent medical treatment and surgical intervention. Surgical treatment includes either chordal sparing mitral valve replacement or mitral valve repair, which is associated with a high mortality. Mitral valve repair is believed to be superior to mitral valve replacement with respect to improving left ventricular function, albeit with risk of repair failure and resulting in increased cross clamp times. Concomitant coronary revascularization may improve both shortand long-term outcomes after surgery. With advances in medical innovations in the field of transcatheter devices, these devices may serve as a bridge to recovery or treatment in the setting of acute MR due to PMR.However, long-term data will be required to establish the non-inferiority of one treatment modality over the other. Management of these patients should be guided by a dedicated mitral heart team.

Totally endoscopic minimally invasive mitral valvuloplasty with a beating heart for treatment of papillary muscle rupture

“… 2 However, mitral valve replacement is still the preferred strategy for most surgeons in cases of PMR (about 80%), which maybe due to the complexity and difficulty of MVP in PMR, prolonged operation time, and controversial valve reintervention. 3 …”

Telesimulation Training for Endoscopic Mitral Valve Surgery: An Air-Pilot Training Concept for Distance Training

“…Suturing maps for endoscopic MV and TV surgery. 15–17 (a) Endoscopic MVr, (b) TVr, and (c) MVR. MVr, mitral valve repair; MVR, mitral valve replacement; TVr, tricuspid valve repair.…”

Pursuit of Excellence: Five Lessons From Dedicated Practice and Seven Key Recommendations for Simulation-Based Training

“…For example, Figure 3 showcases various suturing maps we created for mitral and tricuspid valve surgeries to aid learning. 6–8…”

“…Suturing maps for (a) endoscopic MVr, (b) TVr, and (c) MVR. 6–8 MVr, mitral valve repair; MVR, mitral valve replacement; TVr, tricuspid valve repair.…”