Minimally invasive papillary muscle sling placement during mitral valve repair in patients with functional mitral regurgitation.
BACKGROUND
We evaluated the safety and feasibility of minimally invasive mitral valve repair with papillary muscle sling placement via a right anterior thoracotomy approach in patients with severe functional mitral regurgitation (MR).


METHODS
We retrospectively reviewed all minimally invasive mitral valve repairs with papillary muscle sling placement in patients with severe functional MR performed at our institution between October 2011 and September 2012. The operative times, lengths of stay, postoperative complications, and mortality were analyzed.


RESULTS
We identified a total of 19 consecutive patients. There were 12 men (63%); the mean age was 60 ± 13 years. The mean ± SD left ventricular ejection fraction was 23% ± 5.5%, and 4 (21%) of the patients underwent previous coronary artery bypass graft surgery. The median aortic cross-clamp and cardiopulmonary bypass times were 106 (interquartile range [IQR], 76-120) and 163 (IQR, 119-170) minutes, respectively. The median intensive care unit length of stay was 64 (IQR, 43-75) hours, and the median postoperative length of stay was 7 (IQR, 5-7.5) days. Postoperatively, 2 patients developed acute kidney injury. There were no reoperations for bleeding or any cerebrovascular accidents. The 30-day mortality was 0. A follow-up echocardiogram, obtained at a median of 3 (IQR, 1-7.5) months, demonstrated none to trivial MR in all patients.


CONCLUSIONS
Minimally invasive mitral repair with papillary muscle sling placement for severe functional MR is safe and effective in the short-term. Long-term data are needed to evaluate the effects on left ventricular remodeling and to assess the durability of the repair.
['Santana|Orlando|O|', 'Solenkova|Natalia V|NV|', 'Pineda|Andres M|AM|', 'Mihos|Christos G|CG|', 'Lamelas|Joseph|J|']
D000368:Aged D002315:Cardiopulmonary Bypass D005240:Feasibility Studies D005260:Female D019918:Heart Valve Prosthesis Implantation D006801:Humans D007902:Length of Stay D008297:Male D008875:Middle Aged D008943:Mitral Valve D058386:Mitral Valve Annuloplasty D008944:Mitral Valve Insufficiency D010210:Papillary Muscles D011183:Postoperative Complications D012189:Retrospective Studies D012307:Risk Factors D012720:Severity of Illness Index D013318:Stroke Volume D013908:Thoracotomy D013997:Time Factors D016896:Treatment Outcome D014463:Ultrasonography D016277:Ventricular Function, Left
mitral regurgitation MR interquartile range IQR 28 35 35.4 35.4.1