Papillary muscle sling: a new functional approach to mitral repair in patients with ischemic left ventricular dysfunction and functional mitral regurgitation
In patients with ischemic left ventricular dysfunction (LVD) and functional mitral regurgitation (FMR), restoring a more normal alignment between mitral annulus and laterally displaced papillary muscles (PM) may be beneficial in terms of mitral repair and regional dynamics. Ten patients, 29 to 78 ye...
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| Veröffentlicht in: | The Annals of thoracic surgery 2003-03, Vol.75 (3), p.809-811 |
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| creator | Hvass, Ulrik Tapia, Michel Baron, Frank Pouzet, Bruno Shafy, Abdel |
| description | In patients with ischemic left ventricular dysfunction (LVD) and functional mitral regurgitation (FMR), restoring a more normal alignment between mitral annulus and laterally displaced papillary muscles (PM) may be beneficial in terms of mitral repair and regional dynamics.
Ten patients, 29 to 78 years old, with an ejection fraction of 25% to 45%, pulmonary hypertension greater than 60, and New York Heart Association Class III–IV, had their PMs drawn together by a tightly encircling loop using a 4-mm Gore-Tex tube. Associated mitral annuloplasty rings were only moderately undersized. Efficiency was essentially evaluated on reversal of mitral tenting and control of FMR.
Postoperative echocardioraphy revealed changes in “tenting effect” from 14 ± 2.8 mm to 4 ± 1.41 mm. Regurgitation is none to trivial in 9 patients, and mild in 1 patient. The posterior left ventricular wall between the PMs is shortened as a result of the surgical remodeling and may be beneficial on local dynamics.
Joining the PM side-by-side has an obvious immediate effect on mitral leaflet mobility by suppressing the tethering due to displacement of the PM. An eventual result on local ventricular dynamics needs confirmation. |
| doi_str_mv | 10.1016/S0003-4975(02)04678-7 |
| format | Article |
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Ten patients, 29 to 78 years old, with an ejection fraction of 25% to 45%, pulmonary hypertension greater than 60, and New York Heart Association Class III–IV, had their PMs drawn together by a tightly encircling loop using a 4-mm Gore-Tex tube. Associated mitral annuloplasty rings were only moderately undersized. Efficiency was essentially evaluated on reversal of mitral tenting and control of FMR.
Postoperative echocardioraphy revealed changes in “tenting effect” from 14 ± 2.8 mm to 4 ± 1.41 mm. Regurgitation is none to trivial in 9 patients, and mild in 1 patient. The posterior left ventricular wall between the PMs is shortened as a result of the surgical remodeling and may be beneficial on local dynamics.
Joining the PM side-by-side has an obvious immediate effect on mitral leaflet mobility by suppressing the tethering due to displacement of the PM. An eventual result on local ventricular dynamics needs confirmation.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(02)04678-7</identifier><identifier>PMID: 12645698</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Echocardiography ; Female ; Follow-Up Studies ; Humans ; Male ; Medical sciences ; Middle Aged ; Mitral Valve Insufficiency - diagnostic imaging ; Mitral Valve Insufficiency - surgery ; Myocardial Ischemia - diagnostic imaging ; Myocardial Ischemia - surgery ; Papillary Muscles - diagnostic imaging ; Papillary Muscles - surgery ; Polytetrafluoroethylene ; Postoperative Complications - diagnostic imaging ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Sutures ; Ventricular Dysfunction, Left - diagnostic imaging ; Ventricular Dysfunction, Left - surgery</subject><ispartof>The Annals of thoracic surgery, 2003-03, Vol.75 (3), p.809-811</ispartof><rights>2003 The Society of Thoracic Surgeons</rights><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c426t-d8523c9fb9bff1c26cde723a8d602f188497ff782de178ea3f5d58d01aa3bea33</citedby><cites>FETCH-LOGICAL-c426t-d8523c9fb9bff1c26cde723a8d602f188497ff782de178ea3f5d58d01aa3bea33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0003-4975(02)04678-7$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,782,786,3552,27931,27932,46002</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14598467$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12645698$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hvass, Ulrik</creatorcontrib><creatorcontrib>Tapia, Michel</creatorcontrib><creatorcontrib>Baron, Frank</creatorcontrib><creatorcontrib>Pouzet, Bruno</creatorcontrib><creatorcontrib>Shafy, Abdel</creatorcontrib><title>Papillary muscle sling: a new functional approach to mitral repair in patients with ischemic left ventricular dysfunction and functional mitral regurgitation</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>In patients with ischemic left ventricular dysfunction (LVD) and functional mitral regurgitation (FMR), restoring a more normal alignment between mitral annulus and laterally displaced papillary muscles (PM) may be beneficial in terms of mitral repair and regional dynamics.
Ten patients, 29 to 78 years old, with an ejection fraction of 25% to 45%, pulmonary hypertension greater than 60, and New York Heart Association Class III–IV, had their PMs drawn together by a tightly encircling loop using a 4-mm Gore-Tex tube. Associated mitral annuloplasty rings were only moderately undersized. Efficiency was essentially evaluated on reversal of mitral tenting and control of FMR.
Postoperative echocardioraphy revealed changes in “tenting effect” from 14 ± 2.8 mm to 4 ± 1.41 mm. Regurgitation is none to trivial in 9 patients, and mild in 1 patient. The posterior left ventricular wall between the PMs is shortened as a result of the surgical remodeling and may be beneficial on local dynamics.
Joining the PM side-by-side has an obvious immediate effect on mitral leaflet mobility by suppressing the tethering due to displacement of the PM. An eventual result on local ventricular dynamics needs confirmation.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mitral Valve Insufficiency - diagnostic imaging</subject><subject>Mitral Valve Insufficiency - surgery</subject><subject>Myocardial Ischemia - diagnostic imaging</subject><subject>Myocardial Ischemia - surgery</subject><subject>Papillary Muscles - diagnostic imaging</subject><subject>Papillary Muscles - surgery</subject><subject>Polytetrafluoroethylene</subject><subject>Postoperative Complications - diagnostic imaging</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Sutures</topic><topic>Ventricular Dysfunction, Left - diagnostic imaging</topic><topic>Ventricular Dysfunction, Left - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hvass, Ulrik</creatorcontrib><creatorcontrib>Tapia, Michel</creatorcontrib><creatorcontrib>Baron, Frank</creatorcontrib><creatorcontrib>Pouzet, Bruno</creatorcontrib><creatorcontrib>Shafy, Abdel</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hvass, Ulrik</au><au>Tapia, Michel</au><au>Baron, Frank</au><au>Pouzet, Bruno</au><au>Shafy, Abdel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Papillary muscle sling: a new functional approach to mitral repair in patients with ischemic left ventricular dysfunction and functional mitral regurgitation</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2003-03-01</date><risdate>2003</risdate><volume>75</volume><issue>3</issue><spage>809</spage><epage>811</epage><pages>809-811</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract>In patients with ischemic left ventricular dysfunction (LVD) and functional mitral regurgitation (FMR), restoring a more normal alignment between mitral annulus and laterally displaced papillary muscles (PM) may be beneficial in terms of mitral repair and regional dynamics.
Ten patients, 29 to 78 years old, with an ejection fraction of 25% to 45%, pulmonary hypertension greater than 60, and New York Heart Association Class III–IV, had their PMs drawn together by a tightly encircling loop using a 4-mm Gore-Tex tube. Associated mitral annuloplasty rings were only moderately undersized. Efficiency was essentially evaluated on reversal of mitral tenting and control of FMR.
Postoperative echocardioraphy revealed changes in “tenting effect” from 14 ± 2.8 mm to 4 ± 1.41 mm. Regurgitation is none to trivial in 9 patients, and mild in 1 patient. The posterior left ventricular wall between the PMs is shortened as a result of the surgical remodeling and may be beneficial on local dynamics.
Joining the PM side-by-side has an obvious immediate effect on mitral leaflet mobility by suppressing the tethering due to displacement of the PM. An eventual result on local ventricular dynamics needs confirmation.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12645698</pmid><doi>10.1016/S0003-4975(02)04678-7</doi><tpages>3</tpages></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Aged Biological and medical sciences Echocardiography Female Follow-Up Studies Humans Male Medical sciences Middle Aged Mitral Valve Insufficiency - diagnostic imaging Mitral Valve Insufficiency - surgery Myocardial Ischemia - diagnostic imaging Myocardial Ischemia - surgery Papillary Muscles - diagnostic imaging Papillary Muscles - surgery Polytetrafluoroethylene Postoperative Complications - diagnostic imaging Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Sutures Ventricular Dysfunction, Left - diagnostic imaging Ventricular Dysfunction, Left - surgery |
| title | Papillary muscle sling: a new functional approach to mitral repair in patients with ischemic left ventricular dysfunction and functional mitral regurgitation |
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