Surgical management of left ventricular posterior wall plication for
cardiac shock with ischemic mitral regurgitation
Abstract
Ischemic mitral regurgitation (IMR) is a common complication, which is
accompanied by myocardial infarction, causing heart failure and leading
to poor prognosis. Although several surgical techniques have been
reported, certain surgical methods have not been established for
treating IMR. We report a successful case of left ventricular posterior
wall plication through a left atriotomy over the mitral valve for IMR in
a patient who experienced cardiac shock and could not be weaned off
mechanical support. Posterior wall plication changed the left ventricle
from a spherical to an oval shape, restored the position of papillary
muscles and posterior wall, improved leaflet tethering, and prevented
further remodeling of the left ventricle. This method may be useful for
treating IMR and improve patients’ prognosis.