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Robotic mitral valve repair - Papillary muscle shortening in extensive prolapse
Daniel Tai-leung Chan, Hazaim Alwair, James Aitken, Evelio Rodriguez, Wiley L. Nifong, Randolph W. Chitwood, Jr.
East Carolina University, Greenville, NC, USA.
Background: To demonstrate techniques of robotic repair of extensive leaflet prolapse in a patient with Barlow’s disease
Method: A 56 year old lady with increasing shortness of breath had severe mitral regurgitation on echocardiogram. There was significant anterior leaflet prolapse with redundant valvular tissue. Along with prolapse of the anterior leaflet, the postero-medial commissure was also prolapsing.
Result: Robotic assisted mitral valve repair was performed using the da Vinci™ Surgical System. Using dynamic left atrial retraction, access to the subvalvular structures was achieved. The postero-medial papillary muscle was shortened and the prolapsed area was brought reduced to the new level of leaflet coaptation. This was followed with a commissuroplasty. The mitral valve was competent on post-operative TEE.
Conclusion: Robotic repair of complex valve pathology in Barlow’s disease is feasible. Instead of multiple artificial chords, papillary muscle shortening in this situation offers a fast and reliable repair.
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