I have recently been performing a procedure that may have an added benefit to patients with MR and LV dysfunction. We know that patients with a poor EF and severe MR who undergo a MVRepair may return several months later with recurrent MR. The reason for this is that this is not only an annular problem but is also a ventricular issue. In order to address this, I have added a papillary muscle sling to the MVRepair annuloplasty. This is accomplished with a 4mm gortex graft tightly wrapped around the papillary muscles. One must avoid the sling from sliding up onto the chordea. The sling needs to stay a low as possible on the papillary muscles. I have enclosed 2 intra op pictures to demonstrate this procedure being performed via minimally invasive approach. I have done 5 as of this post and will definitely keep you posted on the results. This is the first time this is performed via a minimally invasive, mini thoracotomy approach. I have a publication in progress as you are reading this blog.

4mm gortex sling

Sling tied to approximate papillary muscles