Continued Global Left Ventricular Remodeling Is Not the Sole Mechanism Responsible for the Late Recurrence of Ischemic Mitral Regurgitation after Restrictive Annuloplasty

Although recurrent MR is often associated with continued adverse LV remodeling after restrictive MVA, this mechanism fails to explain all recurrences. In the absence of LV dilatation, recurrent MR might be explained by localized LV remodeling in the vicinity of papillary muscles resulting in increased AL tethering at the bending point.