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Papillary muscle elevation: an alternative subvalvular procedure for selective relocation of displaced posterior papillary muscle in posteroinferior infarction

Department of Thoracic and Cardiovascular Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima 890-8520, Japan

*Corresponding author. Tel.: +81-99-275-5368; fax: +81-99-265-8177.

E-mail address: tueno{at}m.kufm.kagoshima-u.ac.jp (T.Ueno).

Several subvalvular procedures have been developed for relocating one or both displaced papillary muscles. We describe an original procedure – papillary muscle elevation – in which we relocated the posterior papillary muscle selectively, through a small inferior ventriculotomy, and reduced the coaptation depth from 5 mm to zero. Our procedure can be considered for cases of posteroinferior infarction, which is a frequent cause of ischemic mitral regurgitation.

Key Words: Subvalvular procedure; Papillary muscle relocation; Ischemic mitral regurgitation