scholarly journals Mitral apparatus assessment by delayed enhancement CMR - relative impact of papillary muscle and left ventricular wall infarction on ischemic mitral regurgitation

2012 ◽  
Vol 14 (S1) ◽  
Author(s):  
Parag Goyal ◽  
Jason Chinitz ◽  
Fahmida Islam ◽  
Debbie W Chen ◽  
Sean Wilson ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Papillary Muscle ◽  
Left Ventricular ◽  
Delayed Enhancement ◽  
Ischemic Mitral Regurgitation ◽  
Left Ventricular Wall ◽  
Ventricular Wall ◽  
Relative Impact ◽  
Mitral Apparatus

scholarly journals Combined Papillary Muscle and Left Ventricular Wall Dysfunction as a Cause of Mitral Regurgitation

Circulation ◽  
1971 ◽  
Vol 44 (2) ◽  
pp. 174-180 ◽  
Author(s):  
ARUN K. MITTAL ◽  
MANLY LANGSTON ◽  
KEITH E. COHN ◽  
ARTHUR SELZER ◽  
WILLIAM J. KERTH
Keyword(s):  
Mitral Regurgitation ◽  
Papillary Muscle ◽  
Left Ventricular ◽  
Left Ventricular Wall ◽  
Ventricular Wall

scholarly journals Impact of Papillary Muscle Infarction on Ischemic Mitral Regurgitation Assessed by Magnetic Resonance Imaging

2017 ◽  
Vol 190 (01) ◽  
pp. 42-50 ◽  
Author(s):  
Christiane Bretschneider ◽  
Hannah-Klara Heinrich ◽  
Achim Seeger ◽  
Christof Burgstahler ◽  
Stephan Miller ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Mitral Regurgitation ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Papillary Muscle ◽  
Left Ventricular ◽  
Ischemic Mitral Regurgitation ◽  
Chronic Myocardial Infarction ◽  
End Diastolic Volume ◽  
Significant Difference

Objective Ischemic mitral regurgitation is a predictor of heart failure resulting in increased mortality in patients with chronic myocardial infarction. It is uncertain whether the presence of papillary muscle (PM) infarction contributes to the development of mitral regurgitation in patients with chronic myocardial infarction (MI). The aim of the present study was to assess the correlation of PM infarction depicted by MRI with mitral regurgitation and left ventricular function. Methods and Materials 48 patients with chronic MI and recent MRI and echocardiography were retrospectively included. The location and extent of MI depicted by MRI were correlated with left ventricular function assessed by MRI and mitral regurgitation assessed by echocardiography. The presence, location and extent of PM infarction depicted by late gadolinium enhancement (LGE-) MRI were correlated with functional parameters and compared with patients with chronic MI but no PM involvement. Results PM infarction was found in 11 of 48 patients (23 %) using LGE-MRI. 8/11 patients (73 %) with PM infarction and 22/37 patients (59 %) without PM involvement in MI had ischemic mitral regurgitation. There was no significant difference between location, extent of MI and presence of mitral regurgitation between patients with and without PM involvement in myocardial infarction. In 4/4 patients with complete and in 4/7 patients with partial PM infarction, mitral regurgitation was present. The normalized mean left ventricular end-diastolic volume was increased in patients with ischemic mitral regurgitation. Conclusion The presence of PM infarction does not correlate with ischemic mitral regurgitation. In patients with complete PM infarction and consequent discontinuity of viable tissue in the PM-chorda-mitral valve complex, the probability of developing ischemic mitral regurgitation seems to be increased. However, the severity of mitral regurgitation is not increased compared to patients with partial or no PM infarction. Key points  Citation Format

A three-component force vector cell for in vitro quantification of the force exerted by the papillary muscle on the left ventricular wall

1997 ◽  
Vol 30 (10) ◽  
pp. 1071-1075 ◽  
Author(s):  
Shehab R. Hashim ◽  
Arnold Fontaine ◽  
Shengqiu He ◽  
Robert A. Levine ◽  
Ajit P. Yoganathan
Keyword(s):  
Papillary Muscle ◽  
Left Ventricular ◽  
Left Ventricular Wall ◽  
Ventricular Wall ◽  
Force Vector ◽  
Component Force

Abstract 16801: Papillary Muscle Tip Approximation in Repair of Ischemic Mitral Regurgitation in a Chronic Swine Model

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kanika Kalra ◽  
Samantha Zhan Moodie ◽  
Dongyang Xu ◽  
Muralidhar Padala
Keyword(s):  
Mitral Regurgitation ◽  
Papillary Muscle ◽  
Left Ventricular ◽  
Ischemic Mitral Regurgitation ◽  
Diastolic Filling ◽  
Swine Model ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Post Surgery ◽  
Better Than

Introduction: Mitral valve (MV) repair with undersized annuloplasty (UMA) for ischemic mitral regurgitation (IMR) is being abandoned in favor of valve replacement (MVR) following CTSN trial results. However, in patients with durable repair, survival and left ventricular function (LVF) were significantly better than MVR. Achieving a durable repair with UMA is challenging as it draws leaflets away from papillary muscle (PM) insertions, causing unphysiological tethering and unicuspid configuration that fails (FigA-B). Hypothesis: Drawing PM tips together with an approximating stitch (PMT-A) can relieve leaflet tethering and enable better repair (FigC). A chronic swine model of IMR was used to compare effects of isolated PMT-A, UMA and PMT-A+UMA on MV and LV at 3 months post surgery. Methods: Twenty-five farm swine underwent catheterization and occlusion of left circumflex artery, resulting in postero-lateral myocardial infarction (MI). Two months after MI, IMR severity of >2+ was confirmed on echo, and animals underwent one of the 3 repairs: PMT-A (n=6), UMA (n=8), PMT-A+UMA (n=11). Echo was performed postoperatively and repeated with MRI at 3 months (FigD). MV kinematics, coaptation geometry, and LVF were assessed. Results: IMR was eliminated after all repairs and did not recur through the study. Annulus continued to grow after PMT-A, but not in UMA or PMT-A+UMA group (FigE1) without increasing severity of IMR. Compared to prerepair, tenting depth was significantly reduced only in PMT-A and PMT-A+UMA groups (FigE2). Both leaflet excursion angles (diastolic minus systolic angles) increased after PMT-A, but not in other groups (FigE3-4). LV size and LVF was similar between groups, confirming that PMT-A did not perturb diastolic filling. Conclusions: In this model of IMR, PMT-A improved leaflet mobility, compared to isolated UMA or PMT-A+UMA. PMT-A is a simple technique that can potentially improve durability of MV repair by restoring valvular kinematics.

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