| Does septal-lateral annular cinching work for chronic ischemic mitral regurgitation? | |
| | |
MedLine Citation:
|
PMID: 15001893 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: Ring annuloplasty, the current treatment of choice for chronic ischemic mitral regurgitation, abolishes dynamic annular motion and immobilizes the posterior leaflet. In a model of chronic ischemic mitral regurgitation, we tested septal-lateral annular cinching aimed at maintaining normal annular and leaflet dynamics. METHODS: Twenty-five sheep had radiopaque markers placed on the mitral annulus and anterior and posterior mitral leaflets. A transannular suture was anchored to the midseptal mitral annulus and externalized through the midlateral mitral annulus. After 7 days, biplane cinefluoroscopy provided 3-dimensional marker data (baseline) prior to creating inferior myocardial infarction by snare occlusion of obtuse marginal branches. After 7 weeks, the 9 animals that developed chronic ischemic mitral regurgitation were restudied before and after septal-lateral annular cinching. Anterior and posterior mitral leaflet angular excursion and annular septal-lateral and commissure-commissure dimensions and percent shortening were computed. RESULTS: Septal-lateral annular cinching reduced septal-lateral dimension (baseline: 3.0 +/- 0.2; chronic ischemic mitral regurgitation: 3.5 +/- 0.4 [P <.05 vs baseline by repeated measures analysis of variance and Dunnett's test]; septal-lateral annular cinching: 2.4 +/- 0.3 cm; maximum dimension) and eliminated chronic ischemic mitral regurgitation (baseline: 0.6 +/- 0.5; chronic ischemic mitral regurgitation: 2.3 +/- 1.0 [P <.05 vs baseline by repeated measures analysis of variance and Dunnett's test]; septal-lateral annular cinching: 0.6 +/- 0.6; mitral regurgitation grade [0 to 4+]) but did not alter dynamic annular shortening (baseline: 7 +/- 3; chronic ischemic mitral regurgitation: 10 +/- 5; septal-lateral annular cinching: 6 +/- 2, percent septal-lateral shortening) or posterior mitral leaflet excursion (baseline: 46 degrees +/- 8 degrees; chronic ischemic mitral regurgitation: 41 degrees +/- 13 degrees; septal-lateral annular cinching: 46 degrees +/- 8 degrees ). CONCLUSIONS: In this model, septal-lateral annular cinching decreased chronic ischemic mitral regurgitation, reduced annular septal-lateral diameter (but not commissure-commissure diameter), and maintained normal annular and leaflet dynamics. These findings provide additional insight into the treatment of chronic ischemic mitral regurgitation. |
| | |
Authors:
|
Frederick A Tibayan; Filiberto Rodriguez; Frank Langer; Mary K Zasio; Lynn Bailey; David Liang; George T Daughters; Neil B Ingels; D Craig Miller |
Related Documents
:
|
407263 - Echocardiographic diagnosis of left atrial thrombus - a case report. 10464803 - Pulmonary parenchymal manifestations of mitral valve disease. 22300793 - A rare brainstem hemorrhage during transvenous embolization of a cavernous dural arteri... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The Journal of thoracic and cardiovascular surgery Volume: 127 ISSN: 0022-5223 ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2004 Mar |
Date Detail:
|
Created Date: 2004-03-05 Completed Date: 2004-04-14 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 654-63 Citation Subset: AIM; IM |
Affiliation:
|
Division of Cardiovascular and Thoracic Surgery, Stanford University School of Medicine, Stanford, CA 94305-5247, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Animals Cardiac Surgical Procedures / methods Chronic Disease Echocardiography, Transesophageal Hemodynamics Mitral Valve / physiopathology, surgery* Mitral Valve Insufficiency / etiology, physiopathology, surgery* Myocardial Contraction Myocardial Ischemia / complications* Sheep Suture Techniques |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Is repair of aortic valve regurgitation a safe alternative to valve replacement?
Next Document: Midterm results of endovascular repair of descending thoracic aortic aneurysms with first-generation...