Ischemic mitral valve regurgitation (IMR) is a common consequence of left ventricular remodeling due to chronic coronary artery disease. There are several options for surgical intervention in those with severe symptomatic IMR, ranging from various repair techniques to the AHA/ACC and AATS recommended chordal sparing mitral valve replacement in patients with certain ventricular features. Mitral valve repair may be considered for IMR during concomitant coronary artery bypass grafting if certain criteria are met, but has not been found to improve survival. Ongoing trials are also evaluating the utility of ventricular remodeling using stem cells, percutaneous therapies including leaflet apposition and annular restriction devices, as well as transcatheter mitral valve replacement.
KeywordsChordal sparing mitral valve replacement Chordal tethering Ischemic mitral regurgitation Left ventricular remodelling Papillary muscle displacement
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