Boston - American Association for Thoracic Surgery

89 TH ANNUAL MEETING MAY 9–MAY 13, 2009BOSTON, MASSACHUSETTSRESULTS: At baseline conditions none of the valves had MR, but annular dilatationand PM displacement induced significant MR (Fig 1A). Annuloplasty alonedecreased MR, but did not eliminate it completely at both PM locations (Fig 1A).CT-cut technique reduced residual MR to trace levels only when the PMs wereapically displaced, but did not have a positive effect when the PMs were apicallylaterally-posteriorlydisplaced from their physiological positions (Fig 1A). Tentingarea was reduced to the baseline conditions after CT-cutting in the apical-displacementcase but not in the apical-lateral-posterior displacement case (Fig 1B).CONCLUSION: This study demonstrates that the location of the PMs and theextent of leaflet tethering impact the outcomes of the secondary chordal cuttingsubvalvular repair technique, explaining the variability seen in clinical studies.Therefore, pre-operative assessment of the 3D mitral valve geometry is imperativefor appropriate patient selection for the procedure, optimal surgical planning andimproved outcomes of this procedure.128