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Papillary muscle re-suspension with neo-chordae formation - A novel method to preserve postoperative left ventricular function and dimensions in mitral valve replacement in rheumatic heart disease

Author: 
Dr. Rohit Shahapurkar, Dr. Balaji Aironi and Dr. Kamlesh Jain
Subject Area: 
Health Sciences
Abstract: 

Mitral apparatus plays an important part in maintaining the geometry and LV function (LVEF).In India, Rheumatic valvular heart disease (RHD) is the predominant disease which affects all the components of mitral apparatus with heavy calcification, subvalvular crowding, and chordal fusion. Hence valve repair becomes near impossible. So, we have considered the use of Neo-Chordae with re-suspension of papillary muscles as a simple, easily reproducible method to maintain annulo-papillary continuity and hence post-operative LV dimensions, geometry and LV function. 100 patients underwent Mitral Valve Replacement with chordal re-suspension and were compared with that of non-preserved replacements. Improvement in LV dimension was seen in 80% of patients who had maintained annulo-papillary continuity in the form of papillary muscle re-suspension. 10% rise in LVEF was seen in our study. 24% cases had LV dysfunction in other group with increased LV dimensions almost 20%, post-operatively in this group B.

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