Document Detail


Analysis of left ventricular motion after mitral valve replacement with a technique of preservation of all chordae tendineae. Comparison with conventional mitral valve replacement or mitral valve repair.
MedLine Citation:
PMID:  1513167     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The postoperative regional left ventricular motion of 22 patients with a diagnosis of mitral regurgitation, and who underwent mitral valve replacement with preservation of chordae tendineae, were retrospectively analyzed by cineangiography in the early postoperative period and by multiple-gated cardiac blood pool scintigraphy in the mid-to-late postoperative period. The operation consisted of the division of the anterior leaflet into anterior and posterior segments, the shifting and reattachment of the divided segments to the mitral ring of the respective commissural areas, and the use of a low-profile bileaflet prosthetic valve. Control groups consisted of 28 patients with mitral regurgitation who underwent mitral valve replacement with a conventional technique and 16 patients who underwent mitral valve repair. Compared with the conventional mitral valve replacement group, the radial shortening of the left ventricle of the chordae-preserved mitral valve replacement group was greater at the apical septal, inferoapical, anterobasal, and anterolateral portions, whereas the radial shortening of the repair group was greater than that of the chordae-preserved group only at the inferolateral portion. The ejection fraction of the whole left ventricle was statistically greater in the chordae-preserved group, and also regional ejection fraction of the chordae-preserved mitral valve replacement group was greater at the apical septal, inferoapical, inferolateral, anterobasal, and anterolateral portions than that of the conventional mitral valve replacement group at these portions. On the other hand, the postoperative regional and global motion was identical to that of the mitral valve repair group except at the inferolateral portion. The result of this study supports a concept that maintenance of continuity between the mitral anulus and the papillary muscle has a beneficial effect on postoperative left ventricular performance.
Authors:
Y Okita; S Miki; K Kusuhara; Y Ueda; T Tahata; K Yamanaka; T Higa
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  104     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1992 Sep 
Date Detail:
Created Date:  1992-10-01     Completed Date:  1992-10-01     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  786-95     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Surgery, Tenri Hospital, Nara, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Chordae Tendineae*
Female
Heart Valve Prosthesis*
Humans
Male
Middle Aged
Mitral Valve / surgery*
Mitral Valve Insufficiency / surgery
Postoperative Period
Radionuclide Ventriculography
Retrospective Studies
Stroke Volume
Ventricular Function*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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