| Papillary muscle repositioning in mitral valve replacement in patients with left ventricular dysfunction. | |
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MedLine Citation:
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PMID: 17307440 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The aim of this study was to investigate the feasibility of performing papillary muscle repositioning for mitral valve replacement procedures in patients with left ventricular dysfunction and to determine the early and late effects of this procedure on clinical outcome and left ventricular mechanics. METHODS: One hundred patients with ejection fraction less than 40, who were candidates for isolated surgical correction of mitral insufficiency, had mitral valve replacement and were prospectively randomly assigned to either total chordal-sparing or papillary muscle repositioning. Fifty subjects underwent papillary muscle repositioning (PMR group), and the remaining 50 had complete preservation of all chordal structures with mitral valve replacement (CMVR group). Echocardiography was performed preoperatively, at discharge, and after 2 years to determine dimensions, left ventricular shape, and function. RESULTS: End-diastolic and -systolic volumes decreased in both groups initially and continued to decline. Decreasing volumes, however, were more significant in the PMR group, in which the significant decrease in the sphericity index continued for another 2 years. In contrast, the sphericity index in the CMVR group had no significant changes at discharge and at 2 years. In terms of systolic performance, ejection fraction had no significant changes in the CMVR group, whereas ejection fraction significantly increased in the PMR group. CONCLUSIONS: Papillary muscle repositioning may result in more favorable left ventricular remodeling compared with complete retention of the mitral subvalvular apparatus during mitral valve replacement. It confers a significant early and late advantage by causing significant reductions in the left ventricular chamber volume, sphericity index, and systolic performance. |
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Authors:
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Mohammad Ali Yousefnia; Mohammad Hossein Mandegar; Farideh Roshanali; Farshid Alaeddini; Farshad Amouzadeh |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 83 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-02-19 Completed Date: 2007-03-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 958-63 Citation Subset: AIM; IM |
Affiliation:
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Day General Hospital, Tehran, Iran. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Echocardiography Feasibility Studies Female Follow-Up Studies Heart Valve Prosthesis Implantation / methods* Humans Male Middle Aged Mitral Valve / surgery* Mitral Valve Insufficiency / complications*, surgery* Papillary Muscles / surgery* Stroke Volume Suture Techniques Ventricular Dysfunction, Left / etiology*, physiopathology, ultrasonography Ventricular Remodeling |
| Comments/Corrections | |
Comment In:
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Ann Thorac Surg. 2007 Mar;83(3):963
[PMID:
17307441
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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