Temporal response of left ventricular performance to mitral valve surgery.

Hemodynamic predictors of outcome in patients undergoing valve replacement.

“…Since ejection fraction by radionuclide methods tends to be slightly less than that by contrast ventriculography, it is possible that the postoperative fall in ejection fraction in patients with mitral regurgitation was partially a result of this discrepancy.29 Although we cannot rule this out, a postoperative fall in ejection fraction in patients with preoperative mitral regurgitation has been consistently reported in other studies in which preoperative and postoperative measurement of ejection fraction was made with similar methods. 25,30,31 Our pressures were recorded just before but not simultaneously with left ventriculography. Although it is unlikely that physiologic conditions changed in the minute or two between pressure recording and ventriculography, we cannot entirely exclude this possibility.…”

Depressed contractile function due to canine mitral regurgitation improves after correction of the volume overload.

“…Preoperatively enhanced preload and systolic unloading ofthe left ventricle (via the low impedance pathway into the left atrium) augment ventricular ejection performance (4,5). Postoperatively, ejection performance falls because restoration of mitral competence reduces preload and increases afterload (6,7). Disruption ofthe chordal attachments ofthe valve to the papillary muscles may further worsen ventricular function (8).…”

Improvement in left ventricular dysfunction after surgical correction of mitral regurgitation

“…Ejection fraction reduction is a common finding after mitral valve replacement, even with chordal preservation and mitral valve repair 4,[15][16][17][18] . Ejection fraction and shortening fraction decrease in the postoperative period is also observed in those patients with preserved left ventricular function in the preoperative period 4,19,20 .…”