Restoration of left ventricular systolic performance after reattachment of the mitral chordae tendineae

Sarris, George E.; Cahill, P D; Hansen, David E.; Derby, Geraldine C.; Miller, D. Craig

doi:10.1016/s0022-5223(19)35662-4

Cited by 131 publications

(25 citation statements)

References 35 publications

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“…Postoperatively, in MS patients an increased preload and an improvement of LV geometry by resection of the severely shortened subvalvular apparatus may improve LV function. However, experimental data obtained from normal hearts suggest that severing the continuity between the mitral annulus and PM leads to deterioration of LV function (3,12). Thus, chordal reconstruction could be beneficial for preserving LV function even in MS patients.…”

Section: Discussionmentioning

confidence: 99%

Chordal‐Sparing Mitral Valve Replacement Using Artificial Chordae Tendineae for Rheumatic Mitral Stenosis: Experience of the “Oblique” Method

et al. 2002

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Chordal-sparing mitral valve replacement (CSMVR) has been proven to be beneficial for postoperative left ventricular (LV) function. In patients with mitral stenosis, however, diseased chordae tendineae (CT) often have to be replaced using artificial CT to achieve CSMVR. Previously, we reported that resusupension of artificial CT in an oblique direction enhances systolic LV function. Among 40 consecutive patients with mitral valve replacement (MVR), 17 (4 men and 13 women; mean age 66.5 years) with rheumatic mitral stenosis underwent CSMVR with oblique resuspension. Echocardiography was done before the operation, early (mean 25 days) after the operation, and at a late stage (mean 14 months). There was no mortality or major morbidity. LV ejection fraction late after the operation (68 +/- 8%) was better than that in the early period (61 +/- 8%, p < 0.01), and comparable to the preoperative level (65 +/- 9%). The oblique method may help to improve the results of MVR.

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Section: Discussionmentioning

confidence: 99%

Chordal‐Sparing Mitral Valve Replacement Using Artificial Chordae Tendineae for Rheumatic Mitral Stenosis: Experience of the “Oblique” Method

et al. 2002

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“…Various surgical repairs alter geometry of the papillary muscles, chordae tendinae, and wall of the LV. Even repairs that may at first glance appear to be isolated to the valve have broad-ranging effects on the ventricle as well, as the valve is a crucial component of normal ventricular function [38,39]. To understand these repairs, and the complex interrelationship of stress on the valve and ventricle, a more complete model of the mitral valve and LV in continuity is necessary.…”

Section: Modeling the Mitral Valve 1 LVmentioning

confidence: 99%

Finite Element Modeling of Mitral Valve Repair

Morgan

Pantoja

Weinsaft

et al. 2016

Journal of Biomechanical Engineering

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The mitral valve is a complex structure regulating forward flow of blood between the left atrium and left ventricle (LV). Multiple disease processes can affect its proper function, and when these diseases cause severe mitral regurgitation (MR), optimal treatment is repair of the native valve. The mitral valve (MV) is a dynamic structure with multiple components that have complex interactions. Computational modeling through finite element (FE) analysis is a valuable tool to delineate the biomechanical properties of the mitral valve and understand its diseases and their repairs. In this review, we present an overview of relevant mitral valve diseases, and describe the evolution of FE models of surgical valve repair techniques.

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“…It has been demonstrated in a number of studies that preservation of the annuluspapillary muscle continuity is of paramount importance to preservation of left ventricular function 45,46 . It was the excision and disruption of the subvalvular apparatus that accounted for the significant loss of systolic function and led to the poor outcome in the earlier patients who underwent mitral valve replacement 47,48 . Preservation of the mitral valve apparatus and LV in mitral valve repair in rheumatic and degenerative mitral valve disease has been demonstrated to enhance and maintain left ventricular function and geometry with an associated decrease in wall stress 49,50 .…”

Section: Surgical and Catheter‐based Treatmentsmentioning

confidence: 99%

Catheter‐Based Approach to Mitral Regurgitation

Condado

Vélez-Gimón

2003

J Interven Cardiology

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Mitral Regurgitation (MR) is a common medical problem. MR is also a prognostic factor; patients with severe symptomatic MR have a poor prognosis with an annual mortality rate of 5% without surgical intervention. An anatomic understanding of the normal and regurgitant mitral valve is essential in order to evaluate appropriately the severity and impact of MR. We briefly discuss mitral complex anatomy, MR evaluation, and treatment options (surgical and catheter-based alternatives) according to the type of lesion found. In particular, our group has shown temporal percutaneous annuloplasty and definitive percutaneous edge-to-edge mitral valve repair to be a feasible technique. Recently a study evaluating endovascular mitral valve edge-to-edge repair was successfully initiated by our group. Acute and chronic ischemic mitral regurgitation and special situations, such as paravalvular leaks, hypertrophic obstructive cardiomyopathy, and mixed lesions are also discussed. Future directions may include the percutaneous transcatheter implantation of a bioprosthetic valve in mitral position.

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Restoration of left ventricular systolic performance after reattachment of the mitral chordae tendineae

Cited by 131 publications

References 35 publications

Chordal‐Sparing Mitral Valve Replacement Using Artificial Chordae Tendineae for Rheumatic Mitral Stenosis: Experience of the “Oblique” Method

Chordal‐Sparing Mitral Valve Replacement Using Artificial Chordae Tendineae for Rheumatic Mitral Stenosis: Experience of the “Oblique” Method

Finite Element Modeling of Mitral Valve Repair

Catheter‐Based Approach to Mitral Regurgitation

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