Papillary muscle repositioning as a subvalvular apparatus preservation technique: In mitral stenosis patients with normal left ventricular systolic function

Texas Heart Institute Journal · Ocak 2014

YÖKSİS Kayıtları

Papillary Muscle Repositioning as a Subvalvular Apparatus Preservation Technique in Mitral Stenosis Patients with Normal Left Ventricular Systolic Function

TEXAS HEART INSTITUTE JOURNAL · 2014 SCI-Expanded

DOÇENT ÖMER FARUK ÇİÇEK →

Makale Bilgileri

DergiTexas Heart Institute Journal

Yayın TarihiOcak 2014

Cilt / Sayfa41 · 33-39

DOI10.14503/THIJ-13-3241

Scopus ID2-s2.0-84898861016

Özet Subvalvular apparatus preservation is an important concept in mitral valve replacement (MVR) surgery that is performed to remedy mitral regurgitation. In this study, we sought to determine the effects of papillary muscle repositioning (PMR) on clinical outcomes and echocardiographic left ventricular function in rheumatic mitral stenosis patients who had normal left ventricular systolic function. We prospectively assigned 115 patients who were scheduled for MVR surgery with mechanical prosthesis to either PMR or MVR-only groups. Functional class and echocardiographic variables were evaluated at baseline and at early and late postoperative followup examinations. All values were compared between the 2 groups. The PMR group consisted of 48 patients and the MVR-only group of 67 patients. The 2 groups' baseline characteristics and surgery-related factors (including perioperative mortality) were similar. During the 18-month follow-up, all echocardiographic variables showed a consistent improvement in the PMR group; the mean left ventricular ejection fraction deteriorated significantly in the MVR-only group. Comparison during follow-up of the magnitude of longitudinal changes revealed that decreases in left ventricular end-diastolic and end-systolic diameters and in left ventricular sphericity indices, and increases in left ventricular ejection fractions, were significantly higher in the PMR group than in the MVR-only group. This study suggests that, in patients with rheumatic mitral stenosis and preserved left ventricular systolic function, the addition of papillary muscle repositioning to valve replacement with a mechanical prosthesis improves left ventricular dimensions, ejection fraction, and sphericity index at the 18-month follow-up with no substantial undesirable effect on the surgery-related factors. © 2014 by the Texas Heart® Institute, Houston.

Yazarlar (10)

Gökhan Lafçi

ORCID: 0000-0002-0639-4341

Kerim Cagli

Ömer Faruk Çiçek

ORCID: 0000-0002-4675-3273

Kemal Korkmaz

Osman Turak

Alper Uzun

Adnan Yalçinkaya

Adem Diken

Eren Gunertem

Kumral Çaǧli

Anahtar Kelimeler

Cardiac output Chordae tendineae/surgery Left Left ventricular function Mitral valve replacement Mitral valve stenosis/surgery Papillary muscles/surgery Subvalvular apparatus Tissue preservation/methods Ventricular function