[Mitral valve replacement and papillary muscle approximation after ineffective cardiac resynchronization therapy in a patient with adriamycin-induced cardiomyopathy].

We report a case of adriamycin-induced cardiomyopathy with severe functional mitral regurgitation and congestive heart failure (CHF). Mitral valve replacement (MVR) and papillary muscle approximation (PMA) were effective for this case. A 68-year-old man had adriamycin-induced cardiomyopathy and had required repetitive hospitalizations for CHF for the past 10 years. He also required additional CHF hospitalizations after implantation of a device to perform cardiac resynchronization therapy. His echocardiogram showed severe mitral regurgitation and reduced left ventricular function. We performed MVR and PMA for his functional mitral regurgitation. We preserved the tendinous cords of the anterior and posterior leaflets of the mitral valve. His echocardiogram showed improved left ventricular systolic function and reduced left ventricular volume. He has made satisfactory progress after the operation and he has not required further hospitalizations for CHF. MVR with preservation of bilateral tendinous cords and PMA are very effective procedures for functional mitral regurgitation and intractable cardiomyopathy.