HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Spence, P. A. Articles by Salerno, T. A. Search for Related Content PubMed PubMed Citation Articles by Spence, P. A. Articles by Salerno, T. A.

The Annals of Thoracic Surgery, Vol 41, 363-371, Copyright © 1986 by The Society of Thoracic Surgeons

ARTICLES

Toward a better understanding of the etiology of left ventricular dysfunction after mitral valve replacement: an experimental study with possible clinical implications

PA Spence, CM Peniston, TE David, N Mihic, AK Jabr, P Narini and TA Salerno

The relatively high morbidity and mortality of mitral valve replacement (MVR) appears to be related to an impairment in left ventricular (LV) function. This two-part investigation was designed to assess the effect of MVR on global LV function in an isolated heart preparation and to evaluate whether a mitral prosthesis with a flexible annulus would be of benefit. In Part I (14 pigs), the effects of each step in MVR were studied. Division of the chordae tendineae caused a severe deterioration in LV function (systolic pressure, 180 +/- 13 versus 120 +/- 10 mm Hg; p less than 0.05; developed pressure, 167 +/- 13 versus 108 +/- 11 mm Hg; p less than 0.05; first derivative of LV pressure [dP/dt], 2,630 +/- 300 versus 1,610 +/- 180 mm Hg/sec; p less than 0.05; balloon volume, 30 ml). Fixation of the mitral annulus prior to division of the chordae tendineae resulted in a small decrease (not significant) in LV function but had no effect after the chordae tendineae were divided. In Part II (10 pigs), two mitral annular prostheses were studied: a standard rigid prosthesis and a prosthesis of identical size but with a flexible annulus. LV function was better with the flexible than the rigid prosthesis (systolic pressure, 118 +/- 10 versus 89 +/- 5% control, p less than 0.02; developed pressure, 120 +/- 11 versus 87 +/- 5% control; p less than 0.02; dP/dt, 119 +/- 10 versus 85 +/- 4% control; p less than 0.02; balloon volume, 30 ml).(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				P. Fundaro, P. M Tartara, E. Villa, P. Fratto, S. Campisi, and E. O Vitali Mitral Valve Repair: Is There Still a Place for Suture Annuloplasty? Asian Cardiovasc Thorac Ann, August 1, 2007; 15(4): 351 - 358. [Abstract] [Full Text] [PDF]

				B.-C. Chang, Y.-N. Youn, J.-W. Ha, S.-H. Lim, Y.-S. Hong, and N. Chung Long-term clinical results of mitral valvuloplasty using flexible and rigid rings: A prospective and randomized study J. Thorac. Cardiovasc. Surg., April 1, 2007; 133(4): 995 - 1003. [Abstract] [Full Text] [PDF]

				K. D. Accola, M. L. Scott, P. A. Thompson, G. J. Palmer III, M. E. Sand, and G. Ebra Midterm Outcomes Using the Physio Ring in Mitral Valve Reconstruction: Experience in 492 Patients Ann. Thorac. Surg., April 1, 2005; 79(4): 1276 - 1283. [Abstract] [Full Text] [PDF]

				M. A. Borger, T. M. Yau, V. Rao, H. E. Scully, and T. E. David Reoperative mitral valve replacement: importance of preservation of the subvalvular apparatus Ann. Thorac. Surg., November 1, 2002; 74(5): 1482 - 1487. [Abstract] [Full Text] [PDF]

				j. Cross The Economics of Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 1999; 3(4): 227 - 230. [Abstract] [PDF]

				M. Kestelli, R. Zeybek, G. Onem, E. Tonguc, A. Baltalarli, N. Postaci, R. Demir, and M. Sagban Late Effect of Mechanical Mitral Valve Diameter on Left Ventricular Function Asian Cardiovasc Thorac Ann, March 1, 1999; 7(1): 30 - 32. [Abstract] [Full Text] [PDF]

				A. F. Carpentier, A. Lessana, J. Y. M. Relland, E. Belli, S. Mihaileanu, A. J. Berrebi, E. Palsky, and D. F. Loulmet The ``Physio-Ring'': An Advanced Concept in Mitral Valve Annuloplasty Ann. Thorac. Surg., November 1, 1995; 60(5): 1177 - 1185. [Abstract] [Full Text]

				A. DeAnda Jr, M. Komeda, S. D. Nikolic, G. T. Daughters II, N. B. Ingels, and D. C. Miller Left Ventricular Function, Twist, and Recoil After Mitral Valve Replacement Circulation, November 1, 1995; 92(9): 458 - 466. [Abstract] [Full Text]

				M. Enriquez-Sarano, H. V. Schaff, T. A. Orszulak, A. J. Tajik, K. R. Bailey, and R. L. Frye Valve Repair Improves the Outcome of Surgery for Mitral Regurgitation : A Multivariate Analysis Circulation, February 15, 1995; 91(4): 1022 - 1028. [Abstract] [Full Text]

				T. J. Vander Salm, L. A. Pape, and J. F. Mauser Mitral Valve Replacement With Complete Retention of Native Leaflets Ann. Thorac. Surg., January 1, 1995; 59(1): 52 - 55. [Abstract] [Full Text]

				Y. Okita, S. Miki, Y. Ueda, T. Tahata, T. Sakai, and K. Matsuyama Mitral valve replacement with maintenance of mitral annulopapillary muscle continuity in patients with mitral stenosis J. Thorac. Cardiovasc. Surg., July 1, 1994; 108(1): 42 - 51. [Abstract] [Full Text]