Cryoablation of Papillary Muscles at Surgery for Malignant Ventricular Arrhythmias Due to Mitral Valve Prolapse. 2022

Jitendra Vohra, and Joseph B Morton, and John Morgan, and James Tatoulis
Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Vic, Australia; The Royal Melbourne Hospital, University of Melbourne, Melbourne, Vic, Australia. Electronic address: jitu@vohra1.com.

BACKGROUND Mitral valve prolapse (MVP) is relatively common condition and while generally benign a small subset of patient suffers from malignant ventricular arrhythmias (MVA) and sudden cardiac death (SCD). METHODS We report three cases of mitral valve prolapse, mitral regurgitation and malignant ventricular arrhythmias refractory to medical therapy, who had surgical cryoablation at the time of surgery on the mitral valve. RESULTS During a follow-up period ranging from 3 to 11 years all three patients have remained free of ventricular arrhythmias and cryoablation lesions targeting the base of the papillary muscles have not caused any detrimental effect on the valve function. CONCLUSIONS Surgical cryoablation of papillary muscles as described in this article should be considered in MVP who suffer from MVA, aborted SCD or frequent ventricular ectopics likely to cause LV dysfunction.

UI MeSH Term Description Entries
D008943 Mitral Valve The valve between the left atrium and left ventricle of the heart. Bicuspid Valve,Bicuspid Valves,Mitral Valves,Valve, Bicuspid,Valve, Mitral,Valves, Bicuspid,Valves, Mitral
D008945 Mitral Valve Prolapse Abnormal protrusion or billowing of one or both of the leaflets of MITRAL VALVE into the LEFT ATRIUM during SYSTOLE. This allows the backflow of blood into left atrium leading to MITRAL VALVE INSUFFICIENCY; SYSTOLIC MURMURS; or CARDIAC ARRHYTHMIA. Floppy Mitral Valve,Mitral Click-Murmur Syndrome,Systolic Click-Murmur Syndrome,Click-Murmur Syndrome,Mitral Valve Prolapse Syndrome,Prolapsed Mitral Valve,Click Murmur Syndrome,Click-Murmur Syndrome, Mitral,Click-Murmur Syndrome, Systolic,Click-Murmur Syndromes,Floppy Mitral Valves,Mitral Click Murmur Syndrome,Mitral Valve Prolapses,Mitral Valve, Floppy,Mitral Valve, Prolapsed,Mitral Valves, Floppy,Mitral Valves, Prolapsed,Prolapse, Mitral Valve,Prolapsed Mitral Valves,Prolapses, Mitral Valve,Syndrome, Click-Murmur,Syndrome, Mitral Click-Murmur,Syndrome, Systolic Click-Murmur,Syndromes, Click-Murmur,Systolic Click Murmur Syndrome,Valve Prolapse, Mitral,Valve Prolapses, Mitral,Valve, Prolapsed Mitral,Valves, Prolapsed Mitral
D010210 Papillary Muscles Conical muscular projections from the walls of the cardiac ventricles, attached to the cusps of the atrioventricular valves by the chordae tendineae. Muscle, Papillary,Muscles, Papillary,Papillary Muscle
D003452 Cryosurgery The use of freezing as a special surgical technique to destroy or excise tissue. Cryoablation,Cryoablations,Cryosurgeries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016757 Death, Sudden, Cardiac Unexpected rapid natural death due to cardiovascular collapse within one hour of initial symptoms. It is usually caused by the worsening of existing heart diseases. The sudden onset of symptoms, such as CHEST PAIN and CARDIAC ARRHYTHMIAS, particularly VENTRICULAR TACHYCARDIA, can lead to the loss of consciousness and cardiac arrest followed by biological death. (from Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed., 2005) Cardiac Sudden Death,Sudden Cardiac Death,Cardiac Arrest, Sudden,Sudden Cardiac Arrest,Arrest, Sudden Cardiac,Cardiac Arrests, Sudden,Cardiac Death, Sudden,Death, Cardiac Sudden,Death, Sudden Cardiac,Sudden Death, Cardiac
D018879 Ventricular Premature Complexes A type of cardiac arrhythmia with premature contractions of the HEART VENTRICLES. It is characterized by the premature QRS complex on ECG that is of abnormal shape and great duration (generally >129 msec). It is the most common form of all cardiac arrhythmias. Premature ventricular complexes have no clinical significance except in concurrence with heart diseases. Extrasystole, Ventricular,Premature Ventricular Beats,Premature Ventricular Contractions,Ventricular Ectopic Beats,Premature Ventricular Complex,Ventricular Premature Complex,Ectopic Beat, Ventricular,Ectopic Beats, Ventricular,Premature Ventricular Beat,Premature Ventricular Contraction,Ventricular Beat, Premature,Ventricular Beats, Premature,Ventricular Complex, Premature,Ventricular Contraction, Premature,Ventricular Contractions, Premature,Ventricular Ectopic Beat,Ventricular Extrasystole,Ventricular Extrasystoles

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