| Effects of prosthetic valve placement on mitral annular dynamics and the left ventricular base. | |
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MedLine Citation:
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PMID: 11199318 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Insertion of a rigid mitral prosthesis impairs the function of the mitral annulus and induces systolic narrowing of the left ventricular outflow tract (LVOT). To study this mechanism, we investigated dynamic changes in the left ventricular (LV) base, which consists of the mitral annulus and LVOT orifice. In seven patients with mechanical mitral valve prostheses and eight normal subjects, the image of the LV base was reconstructed three-dimensionally and its dynamic change during systole was studied. In the patients, the rigid prosthetic valve (=mitral annulus) tilted toward the left ventricle with a hinge point at the posterior mitral annulus during systole. The left ventricular base exhibited contraction, but the size of the prosthetic valve was constant. As a consequence, the prosthetic valve occupied more of the left ventricular base, which resulted in narrowing of the LVOT. In the normal subjects, the mitral annulus did not interfere with the region of the LVOT orifice during systole as the mitral annulus underwent both dorsiflexion and contraction. Thus, fixation of the mitral annulus induces an anti-physiologic motion of the annulus. Conscious preservation of annular flexibility in mitral valve surgery is important in avoiding potential dynamic LVOT obstruction. |
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Authors:
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T Komoda; R Hetzer; H Siniawski; J Oellinger; R Felix; C Uyama; H Maeta |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: ASAIO journal (American Society for Artificial Internal Organs : 1992) Volume: 47 ISSN: 1058-2916 ISO Abbreviation: ASAIO J. Publication Date: 2001 Jan-Feb |
Date Detail:
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Created Date: 2001-01-23 Completed Date: 2001-03-22 Revised Date: 2006-05-23 |
Medline Journal Info:
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Nlm Unique ID: 9204109 Medline TA: ASAIO J Country: United States |
Other Details:
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Languages: eng Pagination: 60-5 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery, German Heart Institute Berlin. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Echocardiography Heart Valve Prosthesis* Humans Magnetic Resonance Imaging Male Materials Testing Middle Aged Mitral Valve / physiology* Mitral Valve Insufficiency / physiopathology*, surgery*, ultrasonography Reference Values Stroke Volume Systole Ventricular Function, Left* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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