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Restoring papillary muscle dimensions during restoration in dilated hearts

^a David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 62-258 CHS, Los Angeles, CA 90095-1741, USA
^b San Donato Hospital, Via Morandi 30, Milan, Italy
^c University of Sao Paulo Medical School, Sao Paulo, Brazil
^d Hayama Heart Center, Kanagawa, Japan

*Corresponding author. Tel.: +1-310-206-1027; fax: +1-310-825-5895.

E-mail address: gbuckberg{at}mednet.ucla.edu (G. Buckberg).

Left ventricular papillary muscle geometry is distorted in dilated non-ischemic hearts, and following anterior infarction caused by a wrap around left anterior descending artery occlusion. Loss of the apex creates a spherical left ventricular (LV) chamber, and subsequent dilation causes secondary mitral insufficiency by stretching the annulus, altering tethering of the chords and widening the dimension between the bases of papillary muscles to impair leaflet coaptation. This report will describe an intraventricular way to narrow the widened inter papillary muscle distance toward normal.

Key Words: Dilated heart; Wrap around anterior infarction; Mitral insufficiency; Papillary muscle imbrication; SVR; Ventricular restoration

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