Exploring the Operative Strategy for Secondary Mitral Regurgitation: A Systematic Review

Figure 3

(a–c) The use of subvalvular repair is aimed at correcting the geometric alteration involving subvalvular apparatus. (a) PM relocation fixes the papillary muscle to the posterior and/or anterior trigone. The cutting secondary chordae reduces the tension exerted on the leaflets. (b) The PM approximation reduces the distance between the papillary muscles. (c) The subvalvular repair is effective in restoring correct ventricular geometry.