Mitral Valve Repair

  • Arthur Charles Hill
  • Thomas M. Beaver
  • Jaishankar Raman


Congestive heart failure (CHF) has become an international heath care problem and it is one of the world’s leading causes of hospitalization and mortality. In the United States alone, 4.9 million people (2.3 % of total population) are suffering from heart failure with 550,000 new cases diagnosed each year. Hospital discharge for CHF increased from 377,000 in 1979 to 970,000 in 2002, an increase of 157 %. Estimated health expenditures amount to $ 25.3 billion in 2005 [1]. In spite of these, only 2,100 of the 53,000 patients who die annually are offered transplantation, which many consider to be the standard treatment for selected patients with severe CHF and end-stage heart disease. Transplantation is severely limited by the paucity of donor availability and enormous cost. The inapplicability in the older patient or those with comorbid medical conditions as well as relatively fixed donor pool suggest that transplantation will likely never have a major epidemiological impact [2]. Treatment with mechanical circulatory support devices dances on the horns of the same dilemma. Consequently, despite improvements with medical management, 1 year, 3 year and 5-year survival after hospitalization from CHF have been reported at approximately 80–60 %, 50 % and 40–20 % respectively, which is worse than that of most cancers [3–7].


Mitral valve Reconstruction Mitral repair Mitral regurgitation Functional MR Dilated cardiomyopathy Heart failure 


  1. 1.
    Association AH. Heart disease and stroke statistics – 2005 update. Paper presented at: American Heart Association. Dallas; 2005.Google Scholar
  2. 2.
    Tavazzi L. Epidemiology of dilated cardiomyopathy: a still undetermined entity. Eur Heart J. 1997;18(1):4–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Ho KK, Anderson KM, Kannel WB, Grossman W, Levy D. Survival after the onset of congestive heart failure in Framingham Heart Study subjects. Circulation. 1993;88(1):107–15.PubMedCrossRefGoogle Scholar
  4. 4.
    Khand A, Gemmel I, Clark AL, Cleland JG. Is the prognosis of heart failure improving? J Am Coll Cardiol. 2000;36(7):2284–6.PubMedCrossRefGoogle Scholar
  5. 5.
    Levy D, Kenchaiah S, Larson MG, et al. Long-term trends in the incidence of and survival with heart failure. N Engl J Med. 2002;347(18):1397–402.PubMedCrossRefGoogle Scholar
  6. 6.
    Shahar E, Lee S, Kim J, Duval S, Barber C, Luepker RV. Hospitalized heart failure: rates and long-term mortality. J Card Fail. 2004;10(5):374–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Stewart S, MacIntyre K, Hole DJ, Capewell S, McMurray JJ. More ‘malignant’ than cancer? Five-year survival following a first admission for heart failure. Eur J Heart Fail. 2001;3(3):315–22.PubMedCrossRefGoogle Scholar
  8. 8.
    Boltwood CM, Tei C, Wong M, Shah PM. Quantitative echocardiography of the mitral complex in dilated cardiomyopathy: the mechanism of functional mitral regurgitation. Circulation. 1983;68(3):498–508.PubMedCrossRefGoogle Scholar
  9. 9.
    Izumi S, Miyatake K, Beppu S, et al. Mechanism of mitral regurgitation in patients with myocardial infarction: a study using real-time two-dimensional Doppler flow imaging and echocardiography. Circulation. 1987;76(4):777–85.PubMedCrossRefGoogle Scholar
  10. 10.
    Perloff JK, Roberts WC. The mitral apparatus. Functional anatomy of mitral regurgitation. Circulation. 1972;46(2):227–39.PubMedCrossRefGoogle Scholar
  11. 11.
    Lillehei CW, Levy MJ, Bonnabeau Jr RC. Mitral valve replacement with preservation of papillary muscles and chordae tendineae. J Thorac Cardiovasc Surg. 1964;47:532–43.PubMedGoogle Scholar
  12. 12.
    Sarris GE, Cahill PD, Hansen DE, Derby GC, Miller DC. Restoration of left ventricular systolic performance after reattachment of the mitral chordae tendineae. The importance of valvular-ventricular interaction. J Thorac Cardiovasc Surg. 1988;95(6):969–79.PubMedGoogle Scholar
  13. 13.
    Yun KL, Sintek CF, Miller DC, et al. Randomized trial comparing partial versus complete chordal-sparing mitral valve replacement: effects on left ventricular volume and function. J Thorac Cardiovasc Surg. 2002;123(4):707–14.PubMedCrossRefGoogle Scholar
  14. 14.
    Rodriguez F, Langer F, Harrington KB, et al. Importance of mitral valve second-order chordae for left ventricular geometry, wall thickening mechanics, and global systolic function. Circulation. 2004;110(11 Suppl 1):II115–22.PubMedGoogle Scholar
  15. 15.
    Enriquez-Sarano M. Timing of mitral valve surgery. Heart. 2002;87(1):79–85.PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Carpentier A. Cardiac valve surgery – the “French correction”. J Thorac Cardiovasc Surg. 1983;86(3):323–37.PubMedGoogle Scholar
  17. 17.
    Bolling SF, Deeb GM, Brunsting LA, Bach DS. Early outcome of mitral valve reconstruction in patients with end-stage cardiomyopathy. J Thorac Cardiovasc Surg. 1995;109(4):676–82; discussion 682–73.PubMedCrossRefGoogle Scholar
  18. 18.
    Bach DS, Bolling SF. Early improvement in congestive heart failure after correction of secondary mitral regurgitation in end-stage cardiomyopathy. Am Heart J. 1995;129(6):1165–70.PubMedCrossRefGoogle Scholar
  19. 19.
    Bach DS, Bolling SF. Improvement following correction of secondary mitral regurgitation in end-stage cardiomyopathy with mitral annuloplasty. Am J Cardiol. 1996;78(8):966–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Bolling SF, Pagani FD, Deeb GM, Bach DS. Intermediate-term outcome of mitral reconstruction in cardiomyopathy. J Thorac Cardiovasc Surg. 1998;115(2):381–6; discussion 387–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Akasaka T, Yoshida K, Hozumi T, et al. Restricted coronary flow reserve in patients with mitral regurgitation improves after mitral reconstructive surgery. J Am Coll Cardiol. 1998;32(7):1923–30.PubMedCrossRefGoogle Scholar
  22. 22.
    Flemming MA, Oral H, Rothman ED, Briesmiester K, Petrusha JA, Starling MR. Echocardiographic markers for mitral valve surgery to preserve left ventricular performance in mitral regurgitation. Am Heart J. 2000;140(3):476–82.PubMedCrossRefGoogle Scholar
  23. 23.
    Starling MR, Kirsh MM, Montgomery DG, Gross MD. Impaired left ventricular contractile function in patients with long-term mitral regurgitation and normal ejection fraction. J Am Coll Cardiol. 1993;22(1):239–50.PubMedCrossRefGoogle Scholar
  24. 24.
    Enriquez-Sarano M, Avierinos JF, Messika-Zeitoun D, et al. Quantitative determinants of the outcome of asymptomatic mitral regurgitation. N Engl J Med. 2005;352(9):875–83.PubMedCrossRefGoogle Scholar
  25. 25.
    Otto CM. Timing of surgery in mitral regurgitation. Heart. 2003;89(1):100–5.PubMedCentralPubMedCrossRefGoogle Scholar
  26. 26.
    Conti JB, Mills Jr RM. Mitral regurgitation and death while awaiting cardiac transplantation. Am J Cardiol. 1993;71(7):617–8.PubMedCrossRefGoogle Scholar
  27. 27.
    Lamas GA, Mitchell GF, Flaker GC, et al. Clinical significance of mitral regurgitation after acute myocardial infarction. Survival and ventricular enlargement investigators. Circulation. 1997;96(3):827–33.PubMedCrossRefGoogle Scholar
  28. 28.
    Trichon BH, Felker GM, Shaw LK, Cabell CH, O’Connor CM. Relation of frequency and severity of mitral regurgitation to survival among patients with left ventricular systolic dysfunction and heart failure. Am J Cardiol. 2003;91(5):538–43.PubMedCrossRefGoogle Scholar
  29. 29.
    Blondheim DS, Jacobs LE, Kotler MN, Costacurta GA, Parry WR. Dilated cardiomyopathy with mitral regurgitation: decreased survival despite a low frequency of left ventricular thrombus. Am Heart J. 1991;122(3 Pt 1):763–71.PubMedCrossRefGoogle Scholar
  30. 30.
    Robbins JD, Maniar PB, Cotts W, Parker MA, Bonow RO, Gheorghiade M. Prevalence and severity of mitral regurgitation in chronic systolic heart failure. Am J Cardiol. 2003;91(3):360–2.PubMedCrossRefGoogle Scholar
  31. 31.
    Grigioni F, Enriquez-Sarano M, Zehr KJ, Bailey KR, Tajik AJ. Ischemic mitral regurgitation: long-term outcome and prognostic implications with quantitative Doppler assessment. Circulation. 2001;103(13):1759–64.PubMedCrossRefGoogle Scholar
  32. 32.
    Koelling TM, Aaronson KD, Cody RJ, Bach DS, Armstrong WF. Prognostic significance of mitral regurgitation and tricuspid regurgitation in patients with left ventricular systolic dysfunction. Am Heart J. 2002;144(3):524–9.PubMedCrossRefGoogle Scholar
  33. 33.
    Ellis SG, Whitlow PL, Raymond RE, Schneider JP. Impact of mitral regurgitation on long-term survival after percutaneous coronary intervention. Am J Cardiol. 2002;89(3):315–8.PubMedCrossRefGoogle Scholar
  34. 34.
    Picard MH, Davidoff R, Sleeper LA, et al. Echocardiographic predictors of survival and response to early revascularization in cardiogenic shock. Circulation. 2003;107(2):279–84.PubMedCrossRefGoogle Scholar
  35. 35.
    Popovic ZB, Martin M, Fukamachi K, et al. Mitral annulus size links ventricular dilatation to functional mitral regurgitation. J Am Soc Echocardiogr. 2005;18(9):959–63.PubMedCrossRefGoogle Scholar
  36. 36.
    Rosario LB, Stevenson LW, Solomon SD, Lee RT, Reimold SC. The mechanism of decrease in dynamic mitral regurgitation during heart failure treatment: importance of reduction in the regurgitant orifice size. J Am Coll Cardiol. 1998;32(7):1819–24.PubMedCrossRefGoogle Scholar
  37. 37.
    Otsuji Y, Handschumacher MD, Schwammenthal E, et al. Insights from three-dimensional echocardiography into the mechanism of functional mitral regurgitation: direct in vivo demonstration of altered leaflet tethering geometry. Circulation. 1997;96(6):1999–2008.PubMedCrossRefGoogle Scholar
  38. 38.
    Yiu SF, Enriquez-Sarano M, Tribouilloy C, Seward JB, Tajik AJ. Determinants of the degree of functional mitral regurgitation in patients with systolic left ventricular dysfunction: a quantitative clinical study. Circulation. 2000;102(12):1400–6.PubMedCrossRefGoogle Scholar
  39. 39.
    Hueb AC, Jatene FB, Moreira LF, Pomerantzeff PM, Kallas E, de Oliveira SA. Ventricular remodeling and mitral valve modifications in dilated cardiomyopathy: new insights from anatomic study. J Thorac Cardiovasc Surg. 2002;124(6):1216–24.PubMedCrossRefGoogle Scholar
  40. 40.
    Spoor MT, Geltz A, Bolling SF. Flexible versus nonflexible mitral valve rings for congestive heart failure: differential durability of repair. Circulation. 2006;114(1 Suppl):I67–71.PubMedGoogle Scholar
  41. 41.
    Dent JM, Spotnitz WD, Nolan SP, Jayaweera AR, Glasheen WP, Kaul S. Mechanism of mitral leaflet excursion. Am J Physiol. 1995;269(6 Pt 2):H2100–8.PubMedGoogle Scholar
  42. 42.
    Kaul S, Spotnitz WD, Glasheen WP, Touchstone DA. Mechanism of ischemic mitral regurgitation. An experimental evaluation. Circulation. 1991;84(5):2167–80.PubMedCrossRefGoogle Scholar
  43. 43.
    Green GR, Dagum P, Glasson JR, et al. Mitral annular dilatation and papillary muscle dislocation without mitral regurgitation in sheep. Circulation. 1999;100(19 Suppl):II95–102.PubMedGoogle Scholar
  44. 44.
    Bolen JL, Alderman EL. Ventriculographic and hemodynamic features of mitral regurgitation of cardiomyopathic, rheumatic and nonrheumatic etiology. Am J Cardiol. 1977;39(2):177–83.PubMedCrossRefGoogle Scholar
  45. 45.
    Merin G, Giuliani ER, Pluth JR, Wallace RB, Danielson GK. Surgery for mitral valve incompetence after myocardial infarction. Am J Cardiol. 1973;32(3):322–4.PubMedCrossRefGoogle Scholar
  46. 46.
    Oury JH, Quint RA, Angell WW, Wuerflein RD. Coronary artery vein bypass grafts in patients requiring valve replacement. Surgery. 1972;72(6):1037–47.PubMedGoogle Scholar
  47. 47.
    Pinson CW, Cobanoglu A, Metzdorff MT, Grunkemeier GL, Kay PH, Starr A. Late surgical results for ischemic mitral regurgitation. Role of wall motion score and severity of regurgitation. J Thorac Cardiovasc Surg. 1984;88(5 Pt 1):663–72.PubMedGoogle Scholar
  48. 48.
    Bonow RO, Carabello BA, Chatterjee K, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol. 2006;48(3):e1–148.PubMedCrossRefGoogle Scholar
  49. 49.
    Cooper HA, Gersh BJ. Treatment of chronic mitral regurgitation. Am Heart J. 1998;135(6 Pt 1):925–36.PubMedCrossRefGoogle Scholar
  50. 50.
    Fowler NO, van der Bel-Kahn JM. Indications for surgical replacement of the mitral valve. With particular reference to common and uncommon causes of mitral regurgitation. Am J Cardiol. 1979;44(1):148–57.PubMedCrossRefGoogle Scholar
  51. 51.
    Gann D, Colin C, Hildner FJ, et al. Mitral valve replacement in medically unresponsive congestive heart failure due to papillary muscle dysfunction. Circulation. 1977;56(3 Suppl):II101–4.PubMedGoogle Scholar
  52. 52.
    Schlant RC. Timing of surgery for patients with nonischemic severe mitral regurgitation. Circulation. 1999;99(3):338–9.PubMedCrossRefGoogle Scholar
  53. 53.
    David TE, Uden DE, Strauss HD. The importance of the mitral apparatus in left ventricular function after correction of mitral regurgitation. Circulation. 1983;68(3 Pt 2):II76–82.PubMedGoogle Scholar
  54. 54.
    Hansen DE, Cahill PD, DeCampli WM, et al. Valvular-ventricular interaction: importance of the mitral apparatus in canine left ventricular systolic performance. Circulation. 1986;73(6):1310–20.PubMedCrossRefGoogle Scholar
  55. 55.
    Hansen DE, Sarris GE, Niczyporuk MA, Derby GC, Cahill PD, Miller DC. Physiologic role of the mitral apparatus in left ventricular regional mechanics, contraction synergy, and global systolic performance. J Thorac Cardiovasc Surg. 1989;97(4):521–33.PubMedGoogle Scholar
  56. 56.
    Rastelli GC, Kirklin JW. Hemodynamic state early after prosthetic replacement of mitral valve. Circulation. 1966;34(3):448–61.PubMedCrossRefGoogle Scholar
  57. 57.
    David TE, Burns RJ, Bacchus CM, Druck MN. Mitral valve replacement for mitral regurgitation with and without preservation of chordae tendineae. J Thorac Cardiovasc Surg. 1984;88(5 Pt 1):718–25.PubMedGoogle Scholar
  58. 58.
    Hennein HA, Swain JA, McIntosh CL, Bonow RO, Stone CD, Clark RE. Comparative assessment of chordal preservation versus chordal resection during mitral valve replacement. J Thorac Cardiovasc Surg. 1990;99(5):828–36; discussion 836–27.PubMedGoogle Scholar
  59. 59.
    Horskotte D, Schulte HD, Bircks W, Strauer BE. The effect of chordal preservation on late outcome after mitral valve replacement: a randomized study. J Heart Valve Dis. 1993;2(2):150–8.PubMedGoogle Scholar
  60. 60.
    Okita Y, Miki S, Kusuhara K, et al. Analysis of left ventricular motion after mitral valve replacement with a technique of preservation of all chordae tendineae. Comparison with conventional mitral valve replacement or mitral valve repair. J Thorac Cardiovasc Surg. 1992;104(3):786–95.PubMedGoogle Scholar
  61. 61.
    Pitarys 2nd CJ, Forman MB, Panayiotou H, Hansen DE. Long-term effects of excision of the mitral apparatus on global and regional ventricular function in humans. J Am Coll Cardiol. 1990;15(3):557–63.PubMedCrossRefGoogle Scholar
  62. 62.
    Rozich JD, Carabello BA, Usher BW, Kratz JM, Bell AE, Zile MR. Mitral valve replacement with and without chordal preservation in patients with chronic mitral regurgitation. Mechanisms for differences in postoperative ejection performance. Circulation. 1992;86(6):1718–26.PubMedCrossRefGoogle Scholar
  63. 63.
    Tischler MD, Cooper KA, Rowen M, LeWinter MM. Mitral valve replacement versus mitral valve repair. A Doppler and quantitative stress echocardiographic study. Circulation. 1994;89(1):132–7.PubMedCrossRefGoogle Scholar
  64. 64.
    Akins CW, Hilgenberg AD, Buckley MJ, et al. Mitral valve reconstruction versus replacement for degenerative or ischemic mitral regurgitation. Ann Thorac Surg. 1994;58(3):668–75; discussion 675–66.PubMedCrossRefGoogle Scholar
  65. 65.
    Carpentier A, Deloche A, Dauptain J, et al. A new reconstructive operation for correction of mitral and tricuspid insufficiency. J Thorac Cardiovasc Surg. 1971;61(1):1–13.PubMedGoogle Scholar
  66. 66.
    Duran CG, Pomar JL, Revuelta JM, et al. Conservative operation for mitral insufficiency: critical analysis supported by postoperative hemodynamic studies of 72 patients. J Thorac Cardiovasc Surg. 1980;79(3):326–37.PubMedGoogle Scholar
  67. 67.
    Enriquez-Sarano M, Schaff HV, Orszulak TA, Tajik AJ, Bailey KR, Frye RL. Valve repair improves the outcome of surgery for mitral regurgitation. A multivariate analysis. Circulation. 1995;91(4):1022–8.PubMedCrossRefGoogle Scholar
  68. 68.
    Goldman ME, Mora F, Guarino T, Fuster V, Mindich BP. Mitral valvuloplasty is superior to valve replacement for preservation of left ventricular function: an intraoperative two-dimensional echocardiographic study. J Am Coll Cardiol. 1987;10(3):568–75.PubMedCrossRefGoogle Scholar
  69. 69.
    Kay JH, Zubiate P, Mendez MA, Vanstrom N, Yokoyama T. Mitral valve repair for significant mitral insufficiency. Am Heart J. 1978;96(2):253–62.PubMedCrossRefGoogle Scholar
  70. 70.
    Gaasch WH, Zile MR. Left ventricular function after surgical correction of chronic mitral regurgitation. Eur Heart J. 1991;12(Suppl B):48–51.PubMedCrossRefGoogle Scholar
  71. 71.
    Yun KL, Rayhill SC, Niczporuk MA, et al. Left ventricular mechanics and energetics in the dilated canine heart: acute versus chronic mitral regurgitation. J Thorac Cardiovasc Surg. 1992;104(1):26–39.PubMedGoogle Scholar
  72. 72.
    Lai DT, Timek TA, Dagum P, et al. The effects of ring annuloplasty on mitral leaflet geometry during acute left ventricular ischemia. J Thorac Cardiovasc Surg. 2000;120(5):966–75.PubMedCrossRefGoogle Scholar
  73. 73.
    Levine RA, Hung J, Otsuji Y, et al. Mechanistic insights into functional mitral regurgitation. Curr Cardiol Rep. 2002;4(2):125–9.PubMedCrossRefGoogle Scholar
  74. 74.
    Tibayan FA, Rodriguez F, Langer F, et al. Undersized mitral annuloplasty alters left ventricular shape during acute ischemic mitral regurgitation. Circulation. 2004;110(11 Suppl 1):II98–102.PubMedGoogle Scholar
  75. 75.
    Tibayan FA, Rodriguez F, Langer F, et al. Does septal-lateral annular cinching work for chronic ischemic mitral regurgitation? J Thorac Cardiovasc Surg. 2004;127(3):654–63.PubMedCrossRefGoogle Scholar
  76. 76.
    Timek TA, Lai DT, Tibayan F, et al. Septal-lateral annular cinching abolishes acute ischemic mitral regurgitation. J Thorac Cardiovasc Surg. 2002;123(5):881–8.PubMedCrossRefGoogle Scholar
  77. 77.
    Yu HY, Su MY, Liao TY, Peng HH, Lin FY, Tseng WY. Functional mitral regurgitation in chronic ischemic coronary artery disease: analysis of geometric alterations of mitral apparatus with magnetic resonance imaging. J Thorac Cardiovasc Surg. 2004;128(4):543–51.PubMedCrossRefGoogle Scholar
  78. 78.
    Chen FY, Adams DH, Aranki SF, et al. Mitral valve repair in cardiomyopathy. Circulation. 1998;98(19 Suppl):II124–7.PubMedGoogle Scholar
  79. 79.
    Bishay ES, McCarthy PM, Cosgrove DM, et al. Mitral valve surgery in patients with severe left ventricular dysfunction. Eur J Cardiothorac Surg. 2000;17(3):213–21.PubMedCrossRefGoogle Scholar
  80. 80.
    Bitran D, Merin O, Klutstein MW, Od-Allah S, Shapira N, Silberman S. Mitral valve repair in severe ischemic cardiomyopathy. J Card Surg. 2001;16(1):79–82.PubMedCrossRefGoogle Scholar
  81. 81.
    Rothenburger M, Rukosujew A, Hammel D, et al. Mitral valve surgery in patients with poor left ventricular function. Thorac Cardiovasc Surg. 2002;50(6):351–4.PubMedCrossRefGoogle Scholar
  82. 82.
    Calafiore AM, Mauro MD, Gallina S, et al. Surgical treatment of mitral valve regurgitation in dilated cardiomyopathy. Heart Surg Forum. 2004;7(1):21–5.PubMedGoogle Scholar
  83. 83.
    Acker MA, Bolling S, Shemin R, et al. Mitral valve surgery in heart failure: insights from the acorn clinical trial. J Thorac Cardiovasc Surg. 2006;132(3):568–77, 577 e561–564.PubMedCrossRefGoogle Scholar
  84. 84.
    Smith PK, Puskas JD, Ascheim DA, Voisine P, Gelijns AC, Moskowitz AJ, (for NIH Clinical Trials consortium), et al. Surgical treatment of moderate ischemic mitral regurgitation. NEJM. 2014. doi: 10.1056/NEJMoa1410490.Google Scholar
  85. 85.
    Sundt TF. Surgery for ischemic mitral regurgitation November 18, 2014. doi: 10.1056/NEJMe1412045.
  86. 86.
    McCarthy PM. Does the intertrigonal distance dilate? Never say never. J Thorac Cardiovasc Surg. 2002;124(6):1078–9.PubMedCrossRefGoogle Scholar
  87. 87.
    Miller DC. Ischemic mitral regurgitation redux – to repair or to replace? J Thorac Cardiovasc Surg. 2001;122(6):1059–62.PubMedCrossRefGoogle Scholar
  88. 88.
    Hung J, Papakostas L, Tahta SA, et al. Mechanism of recurrent ischemic mitral regurgitation after annuloplasty: continued LV remodeling as a moving target. Circulation. 2004;110(11 Suppl 1):II85–90.PubMedGoogle Scholar
  89. 89.
    Matsunaga A, Tahta SA, Duran CM. Failure of reduction annuloplasty for functional ischemic mitral regurgitation. J Heart Valve Dis. 2004;13(3):390–7; discussion 397–8.PubMedGoogle Scholar
  90. 90.
    Tahta SA, Oury JH, Maxwell JM, Hiro SP, Duran CM. Outcome after mitral valve repair for functional ischemic mitral regurgitation. J Heart Valve Dis. 2002;11(1):11–8; discussion 18–9.PubMedGoogle Scholar
  91. 91.
    Bolling SF. Mitral valve reconstruction in the patient with heart failure. Heart Fail Rev. 2001;6(3):177–85.PubMedCrossRefGoogle Scholar
  92. 92.
    Bolling SF. Mitral reconstruction in cardiomyopathy. J Heart Valve Dis. 2002;11 Suppl 1:S26–31.PubMedGoogle Scholar
  93. 93.
    Wu AH, Aaronson KD, Bolling SF, Pagani FD, Welch K, Koelling TM. Impact of mitral valve annuloplasty on mortality risk in patients with mitral regurgitation and left ventricular systolic dysfunction. J Am Coll Cardiol. 2005;45(3):381–7.PubMedCrossRefGoogle Scholar
  94. 94.
    Mehra MR, Griffith BP. Is mitral regurgitation a viable treatment target in heart failure? The plot just thickened. J Am Coll Cardiol. 2005;45(3):388–90.PubMedCrossRefGoogle Scholar
  95. 95.
    Patel JB, Borgeson DD, Barnes ME, Rihal CS, Daly RC, Redfield MM. Mitral regurgitation in patients with advanced systolic heart failure. J Card Fail. 2004;10(4):285–91.PubMedCrossRefGoogle Scholar
  96. 96.
    Bouma W, van der Horst ICC, Hamer IJW, Erasmus ME, et al. Chronic ischaemic mitral regurgitation. Current treatment results and new mechanism-based surgical approaches. Eur J Cardiothorac Surg, 2010;37:170-85. doi: 10.1016/j.ejcts.2009.07.008.
  97. 97.
    Acker MA, Parides MK, Perrault LP, et al. Mitral-valve repair versus replacement for severe ischemic mitral regurgitation. N Engl J Med. 2014;370:23–32.PubMedCentralPubMedCrossRefGoogle Scholar
  98. 98.
    Hendren WG, Nemec JJ, Lytle BW, et al. Mitral valve repair for ischemic mitral insufficiency. Ann Thorac Surg. 1991;52(6):1246–51; discussion 1251–42.PubMedCrossRefGoogle Scholar
  99. 99.
    Menicanti L, Di Donato M, Frigiola A, et al. Ischemic mitral regurgitation: intraventricular papillary muscle imbrication without mitral ring during left ventricular restoration. J Thorac Cardiovasc Surg. 2002;123(6):1041–50.PubMedCrossRefGoogle Scholar
  100. 100.
    Liel-Cohen N, Guerrero JL, Otsuji Y, et al. Design of a new surgical approach for ventricular remodeling to relieve ischemic mitral regurgitation: insights from 3-dimensional echocardiography. Circulation. 2000;101(23):2756–63.PubMedCrossRefGoogle Scholar
  101. 101.
    Messas E, Guerrero JL, Handschumacher MD, et al. Chordal cutting: a new therapeutic approach for ischemic mitral regurgitation. Circulation. 2001;104(16):1958–63.PubMedCrossRefGoogle Scholar
  102. 102.
    Hvass U, Tapia M, Baron F, Pouzet B, Shafy A. Papillary muscle sling: a new functional approach to mitral repair in patients with ischemic left ventricular dysfunction and functional mitral regurgitation. Ann Thorac Surg. 2003;75(3):809–11.PubMedCrossRefGoogle Scholar
  103. 103.
    Kron IL, Green GR, Cope JT. Surgical relocation of the posterior papillary muscle in chronic ischemic mitral regurgitation. Ann Thorac Surg. 2002;74(2):600–1.PubMedCrossRefGoogle Scholar
  104. 104.
    Inoue M, McCarthy PM, Popovic ZB, et al. The coapsys device to treat functional mitral regurgitation: in vivo long-term canine study. J Thorac Cardiovasc Surg. 2004;127(4):1068–76; discussion 1076–67.PubMedCrossRefGoogle Scholar
  105. 105.
    Hung J, Guerrero JL, Handschumacher MD, Supple G, Sullivan S, Levine RA. Reverse ventricular remodeling reduces ischemic mitral regurgitation: echo-guided device application in the beating heart. Circulation. 2002;106(20):2594–600.PubMedCrossRefGoogle Scholar
  106. 106.
    Kaye DM, Byrne M, Alferness C, Power J. Feasibility and short-term efficacy of percutaneous mitral annular reduction for the therapy of heart failure-induced mitral regurgitation. Circulation. 2003;108(15):1795–7.PubMedCrossRefGoogle Scholar
  107. 107.
    St Goar FG, Fann JI, Komtebedde J, et al. Endovascular edge-to-edge mitral valve repair: short-term results in a porcine model. Circulation. 2003;108(16):1990–3.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Ltd. 2016

Authors and Affiliations

  • Arthur Charles Hill
    • 1
  • Thomas M. Beaver
    • 2
  • Jaishankar Raman
    • 3
  1. 1.Division of Cardiothoracic Surgery, Department of SurgeryUniversity of CaliforniaSan FranciscoUSA
  2. 2.Thoracic and Cardiovascular SurgeryUF Health at ShandsGainesvilleUSA
  3. 3.Cardiovascular & Thoracic SurgeryRush University Medical CenterChicagoUSA

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