-
Journal of Cardiovascular... Apr 2022
Topics: Catheter Ablation; Catheters; Humans; Papillary Muscles; Tachycardia, Ventricular
PubMed: 35132708
DOI: 10.1111/jce.15403 -
Disease-a-month : DM Jan 1972
Review
Topics: Aged; Animals; Arteriosclerosis; Cardiac Catheterization; Cardiomegaly; Cardiomyopathies; Catecholamines; Coronary Vessels; Dogs; Echocardiography; Electrocardiography; Female; Heart Auscultation; Heart Diseases; Heart Failure; Humans; Ischemia; Male; Middle Aged; Mitral Valve; Mitral Valve Insufficiency; Myocardial Infarction; Oxygen; Papillary Muscles; Radiography; Shock, Hemorrhagic
PubMed: 4257901
DOI: No ID Found -
European Heart Journal Nov 2019
Topics: Aged; Cardiomyopathies; Echocardiography, Transesophageal; Fatal Outcome; Female; Humans; Imaging, Three-Dimensional; Mitral Valve Insufficiency; Papillary Muscles; Rupture, Spontaneous
PubMed: 31377807
DOI: 10.1093/eurheartj/ehz549 -
JACC. Clinical Electrophysiology Dec 2022
Topics: Humans; Papillary Muscles; Heart Ventricles; Mitral Valve Insufficiency
PubMed: 36543497
DOI: 10.1016/j.jacep.2022.08.030 -
The Journal of Thoracic and... Dec 2023Isolated tricuspid ring annuloplasty remains the surgical standard for functional tricuspid regurgitation repair but offers suboptimal results when right ventricular...
OBJECTIVE
Isolated tricuspid ring annuloplasty remains the surgical standard for functional tricuspid regurgitation repair but offers suboptimal results when right ventricular dilation and remodeling along with papillary muscle displacement is present. Addressing subvalvular remodeling with papillary muscle approximation may improve clinical outcomes.
METHODS
Functional tricuspid regurgitation and biventricular dysfunction were induced in 8 healthy sheep by rapid ventricular pacing (200-240 bpm) for 27 ± 6 days. Subsequently, animals underwent cardiopulmonary bypass for implantation of sonomicrometry crystals on the tricuspid annulus, right ventricle, and papillary muscle tips. Papillary approximation sutures were anchored between anterior-posterior and anterior-septal papillary muscles and externalized through right ventricular free wall to epicardial tourniquets. After weaning from cardiopulmonary bypass, sequential papillary muscle approximations were performed. Simultaneous hemodynamic, sonomicrometry, and echocardiographic data were collected at baseline and after each papillary muscle approximation.
RESULTS
With rapid pacing, right ventricular fractional area change decreased from 59 ± 6% to 38 ± 8% (P < .001), whereas tricuspid annulus diameter increased from 2.4 ± 0.3 cm to 3.3 ± 0.6 cm (P = .003). Tricuspid regurgitation (0-4+) increased from +0 ± 0 to +3.3 ± 0.7 (P < .001). Both anterior-posterior and anterior-septal papillary muscle approximation significantly reduced functional tricuspid regurgitation from +3.3 ± 0.7 to +2 ± 0.5 and +1.9 ± 0.6, respectively (P < .001). Reduction of tricuspid insufficiency with both subvalvular interventions was associated with decreased distance of the anterior papillary muscle to the annular centroid.
CONCLUSIONS
Papillary muscle approximations were effective in reducing severe ovine functional tricuspid regurgitation associated with right ventricular dilation and papillary muscle displacement. Further studies are needed to evaluate efficacy of this adjunct to ring annuloplasty in repair of severe functional tricuspid regurgitation.
Topics: Sheep; Animals; Tricuspid Valve Insufficiency; Papillary Muscles; Tricuspid Valve; Heart Ventricles; Hemodynamics
PubMed: 37330209
DOI: 10.1016/j.jtcvs.2023.05.039 -
The Thoracic and Cardiovascular Surgeon Mar 2022We performed "Papillary muscle heads focalization" for three patients with severe functional mitral regurgitation with severe leaflet tethering (coaptation distance...
We performed "Papillary muscle heads focalization" for three patients with severe functional mitral regurgitation with severe leaflet tethering (coaptation distance ≥1 cm and/or posterior leaflet angle ≥45 degrees). All separated papillary muscle heads were sutured together and both the anterolateral and posteromedial papillary muscles were reconstructed as single head papillary muscles. The stitches are positioned to adjust the levels of mitral leaflet tips, concerning the length of the marginal chordae connected to each head. A downsized annuloplasty is performed concomitantly. At discharge, no patient showed moderate/severe mitral regurgitation. Their coaptation lengths were 7.1, 8.5, and 8.3 mm.
Topics: Humans; Mitral Valve; Mitral Valve Annuloplasty; Mitral Valve Insufficiency; Papillary Muscles; Treatment Outcome
PubMed: 33831965
DOI: 10.1055/s-0040-1722730 -
Cardiovascular Intervention and... Jan 2021
Topics: Aortic Valve; Aortic Valve Stenosis; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Papillary Muscles; Transcatheter Aortic Valve Replacement; Treatment Outcome
PubMed: 32144712
DOI: 10.1007/s12928-020-00654-6 -
Journal of Cardiac Surgery Mar 1994The interactions between the mitral valve and left ventricle are complex and not yet completely understood. However, continuity between the papillary muscles and the... (Review)
Review
The interactions between the mitral valve and left ventricle are complex and not yet completely understood. However, continuity between the papillary muscles and the mitral annulus is probably the most important factor in this relationship because severance of the chordae tendineae in experimental animals causes a significant drop in left ventricular systolic function as assessed by load independent parameters. This deterioration in ventricular function is even more marked in dilated hearts due to chronic mitral regurgitation. There is strong clinical evidence that maintenance of papillary muscle-annular continuity during mitral valve surgery is beneficial to left ventricular function and clinical outcome. That is one of the reasons why the mitral valve should be repaired rather than replaced in patients who need mitral valve surgery. If replacement is necessary, the chordae tendineae should be preserved. If preservation of chordae tendineae is difficult because of calcification, fibrosis, or for other reasons it is possible to resuspend the papillary muscle with expanded tetrafluoroethylene sutures. Preservation of chordae tendineae during mitral valve replacement is also important because it prevents spontaneous rupture of the posterior wall of the left ventricle, a rare but dreaded complication of this type of surgery.
Topics: Animals; Chordae Tendineae; Humans; Mitral Valve; Papillary Muscles; Ventricular Function, Left
PubMed: 8186577
DOI: 10.1111/j.1540-8191.1994.tb00937.x -
Journal of Cardiovascular... Jul 2021
Topics: Echocardiography; Humans; Mitral Valve; Mitral Valve Insufficiency; Papillary Muscles
PubMed: 33993578
DOI: 10.1111/jce.15103 -
Heart Rhythm Nov 2017
Review
Topics: Catheter Ablation; Electrocardiography; Heart Conduction System; Humans; Myocardial Contraction; Papillary Muscles; Tachycardia, Ventricular
PubMed: 28668624
DOI: 10.1016/j.hrthm.2017.06.036