Papillary muscle relocation and annular repositioning for functional tricuspid regurgitation

HeartMate 3 implantation for dextro‐transposition of the great arteries after Mustard procedure: A technique of papillary muscle repositioning

“…Excision of trabeculations and the moderator band have been reported, [4][5][6] but the management of intersecting papillary muscle has not been described in this setting. Papillary muscle repositioning is a technique that is utilized for mitral 7 or tricuspid 8…”

“…Excision of trabeculations and the moderator band have been reported, 4 , 5 , 6 but the management of intersecting papillary muscle has not been described in this setting. Papillary muscle repositioning is a technique that is utilized for mitral 7 or tricuspid 8 valve repair. Suture redirection of the papillary head changes the vector of chordal attachments and of the atrioventricular valve leaflets while preserving the ventricular geometry.…”

Commentary: Functional tricuspid regurgitation: Finally, a ventricular solution to a ventricular problem

“…Notable, the geometry of the RV is more complex, more variable, and more difficult to reliably image than the left ventricle. 1 In this report, Takeshita and colleagues 2 present 2 subvalvular techniques to address chordal tethering and functional TR with papillary repositioning and annular repositioning, highlighting the importance of ventricular components contributing to this disease.…”

Commentary: Subvalvular procedures offer hope for better results in tricuspid valve repair

“…Whereas repeated surgery was required for 2 patients and 2 patients died at 30 days, in such a small study of high-risk patients, the data obtained add to the wealth of promising reports exploring TV subvalvular procedures in adjunct to TVR. [6][7][8][9][10] Although we may still wonder about the reasons for reoperations and death in the current study, such numbers are often expected when performing similar surgery, and we are remiss to not contextualize such findings. In appropriate clinical scenarios that necessitate thinking outside the box, this technique will be handy, especially in situations where no individual approach has been shown to be superior.…”