Right papillary muscle sling: proof of concept and pilot clinical experience
| Autor: | Nawwar Al-Attar, Ulrik Hvass |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Mitral Valve Annuloplasty Swine Diastole Pilot Projects Cardiac Valve Annuloplasty Statistics Nonparametric Internal medicine Mitral valve medicine.artery medicine Animals Humans cardiovascular diseases Systole Papillary muscle Aged Tricuspid valve Ejection fraction business.industry General Medicine Middle Aged Papillary Muscles Magnetic Resonance Imaging Tricuspid Valve Insufficiency Surgery medicine.anatomical_structure Ventricle Pulmonary artery cardiovascular system Cardiology Feasibility Studies Mitral Valve Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 43:e187-e189 |
| ISSN: | 1873-734X 1010-7940 |
| DOI: | 10.1093/ejcts/ezt100 |
| Popis: | OBJECTIVES: Left-sided intraventricular remodelling by papillary muscle approximation associated with annuloplasty of the mitral valve improved outcomes for severe functional mitral regurgitation compared with annuloplasty alone. We conceived of, and studied, a papillary muscle sling on the right side of the heart associated with annuloplasty, seeking to reduce tricuspid valve tethering and right ventricular volumes and to preserve ventricular function. METHODS: An experimental model on ex vivo porcine hearts established the anatomical feasibility of the procedure. A first-in-man clinical series of 5 patients (3 men) with a mean age of 63.3 years (51–73) had mean right ventricular volumes of 320 ml (280–350) and 200 ml (155–250) in diastole and systole, respectively, and an ejection fraction of 30% (25–40). The mean pulmonary artery pressure was 60 mmHg (55–70), and all had Grade IV/IV tricuspid regurgitation (TR). RESULTS: There was no operative mortality. Post-repair, magnetic resonance imaging and echocardiographic studies showed mean right ventricle volumes of 165 ml (155–180) and 124 ml (110–140) in diastole and systole, respectively, and an ejection fraction of 28% (25–35) (P= 0.03). TR was |
| Databáze: | OpenAIRE |
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