Hata Masatoshi, Bleiziffer Sabine, Schramm René, Gummert Jan F
Thorac Cardiovasc Surg. 2022 Mar;70(2):133-135. doi: 10.1055/s-0040-1722730. Epub 2021 Apr 8.
We performed "Papillary muscle heads focalization" for three patients with severe functional mitral regurgitation with severe leaflet tethering (coaptation distance ≥1 cm and/or posterior leaflet angle ≥45 degrees). All separated papillary muscle heads were sutured together and both the anterolateral and posteromedial papillary muscles were reconstructed as single head papillary muscles. The stitches are positioned to adjust the levels of mitral leaflet tips, concerning the length of the marginal chordae connected to each head. A downsized annuloplasty is performed concomitantly. At discharge, no patient showed moderate/severe mitral regurgitation. Their coaptation lengths were 7.1, 8.5, and 8.3 mm.
我们对三名伴有严重瓣叶牵拉（瓣叶对合距离≥1厘米和/或后叶角度≥45度）的严重功能性二尖瓣反流患者进行了“乳头肌头集中化”手术。所有分离的乳头肌头都缝合在一起，前外侧和后内侧乳头肌均重建为单头乳头肌。根据连接到每个乳头肌头的边缘腱索长度，调整缝线位置以调节二尖瓣叶尖的高度。同时进行缩小的瓣环成形术。出院时，没有患者出现中度/重度二尖瓣反流。他们的瓣叶对合长度分别为7.1、8.5和8.3毫米。
