scholarly journals The papillary muscles as shock absorbers of the mitral valve complex. An experimental study☆☆☆

2007 ◽  
Vol 32 (1) ◽  
pp. 96-101 ◽  
Author(s):  
Thomas M. Joudinaud ◽  
Corrine L. Kegel ◽  
Erwan M. Flecher ◽  
Patricia A. Weber ◽  
Emmanuel Lansac ◽  
...  
Keyword(s):  
Experimental Study ◽  
Mitral Valve ◽  
Papillary Muscles ◽  
Shock Absorbers

scholarly journals Biomechanical-Structural Correlation of Chordae tendineae in Animal Models: A Pilot Study

Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1678
Author(s):  
Justyn Gach ◽  
Izabela Janus ◽  
Agnieszka Mackiewicz ◽  
Tomasz Klekiel ◽  
Agnieszka Noszczyk-Nowak
Keyword(s):  
Mitral Valve ◽  
Complex Structure ◽  
Future Research ◽  
Uniaxial Tensile ◽  
Uniaxial Tensile Test ◽  
Histopathological Analysis ◽  
Papillary Muscles ◽  
Chordae Tendineae ◽  
Structural Correlation ◽  
Ring Valve

The mitral valve apparatus is a complex structure consisting of the mitral ring, valve leaflets, papillary muscles and chordae tendineae (CT). The latter are mainly responsible for the mechanical functions of the valve. Our study included investigations of the biomechanical and structural properties of CT collected from canine and porcine hearts, as there are no studies about these properties of canine CT. We performed a static uniaxial tensile test on CT samples and a histopathological analysis in order to examine their microstructure. The results were analyzed to clarify whether the changes in mechanical persistence of chordae tendineae are combined with the alterations in their structure. This study offers clinical insight for future research, allowing for an understanding of the process of chordae tendineae rupture that happens during degenerative mitral valve disease—the most common heart disease in dogs.

scholarly journals Early Clinical Results After Stentless Mitral Valve Implantation and Comparison With Conventional Valve Repair or Replacement

Circulation ◽  
1999 ◽  
Vol 100 (suppl_2) ◽  
Author(s):  
Thomas Walther ◽  
Claudia Walther ◽  
Volkmar Falk ◽  
Anno Diegeler ◽  
Ralf Krakor ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Maximum Flow ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Papillary Muscles ◽  
Valve Repair ◽  
Promising Alternative ◽  
Ventricular Ejection Fraction

Background —A new quadricusp stentless mitral bioprosthetic valve (QMV) is evaluated and compared with current standards. Methods and Results —Since August 1997, 67 patients were prospectively evaluated: 23 patients received a QMV, 23 had mitral valve repair (MVR), and 21 received conventional mitral valve replacement (MVP). Patient age was 69±8, 64±10, and 62±9 years for QMV, MVR, and MVP treatment, respectively. The underlying pathology was mitral stenosis, incompetence, and mixed disease in a corresponding 8, 9, and 6 patients for QMV, 1, 22, and 0 patients for MVR, and 2, 12, and 7 patients for MVP. The papillary muscles were sufficient in all QMV cases to suspend the valve. Cross-clamp time was 59±19 minutes for QMV implantation. In-hospital mortality for QMV, MVR, and MVP was 1, 0, and 0 patients, respectively, and thoracotomy had to be performed again in 1, 1, and 2 patients, respectively (these outcomes were not valve related). At baseline transthoracic echocardiography, respective maximum flow velocities were 1.6, 1.4, and 1.7 m/s, and valve orifice area was 2.6, 3.5, and 3.4 cm 2 . Mild transvalvular reflux was seen in 8, 7, and 2 patients; moderate reflux, in 1, 1, and 1 patients. Left ventricular ejection fraction was 52%, 54%, and 51% in the respective treatment groups. At follow-up, hemodynamic parameters had further improved in all groups. Conclusions —One year after clinical implantation, the QMV appears to function well and has no additional risks compared with MVR or MVP. The subvalvular apparatus is preserved by suspending the QMV at the papillary muscles; this arrangement is hemodynamically advantageous. Echocardiography reveals an excellent valve performance that resembles native mitral valve morphology and hemodynamic function. The QMV is a promising alternative for biological mitral valve replacement.

Quantitative Analysis of Fiber Disarray Developing in Papillary Muscles Unloaded after Mitral Valve Replacement

1989 ◽  
Vol 39 (12) ◽  
pp. 779-785
Author(s):  
Fumiaki Tezuka ◽  
Ikuro Sato ◽  
Hiroki Mori ◽  
Masuko Nomura ◽  
Waldemar Hort
Keyword(s):  
Quantitative Analysis ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Papillary Muscles

Biomechanics of the Mitral Valve in Ischemic Heart Disease: Translating From the Bench to the Operating Room

2010 ◽  
Author(s):  
Muralidhar Padala ◽  
Ajit P. Yoganathan
Keyword(s):  
Blood Flow ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Left Atrium ◽  
Mitral Annulus ◽  
Normal Function ◽  
Force Balance ◽  
Papillary Muscles ◽  
Atrioventricular Valve ◽  
Main Components

The Mitral Valve (MV) is the left atrioventricular valve that controls blood flow between the left atrium and the left ventricle (Fig 1A-B). It has four main components: (i) the mitral annulus — a fibromuscular ring at the base of the left atrium and the ventricle; (ii) two collagenous planar leaflets — anterior and posterior; (iii) web of chordae and (iv) two papillary muscles (PM) that are part of the left ventricle (LV). Normal function of the mitral valve involves a delicate force balance between different components of the valve.

scholarly journals Total replacement of the mitral apparatus with a stentless, chordally supported mitral valve allograft: An experimental study

1996 ◽  
Vol 111 (3) ◽  
pp. 595-604 ◽  
Author(s):  
Herbert Vetter ◽  
Andreas Nerlich ◽  
Ulrich Welsch ◽  
Kangxiong Liao ◽  
Andreas Dagge ◽  
...  
Keyword(s):  
Experimental Study ◽  
Mitral Valve ◽  
Total Replacement ◽  
Mitral Apparatus

On the Interaction of Natural and Mechanical Heart Valve Leaflets With the Chordae Tendineae

2002 ◽  
Author(s):  
Amber R. Mace ◽  
Pavlos P. Vlachos ◽  
Demetri P. Telionis
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Mechanical Heart Valve ◽  
Postoperative Mortality ◽  
Decisive Role ◽  
Flow Dynamics ◽  
Papillary Muscles ◽  
Posterior Leaflet ◽  
Chordae Tendineae ◽  
Atrioventricular Ring

Long before mitral valve replacement (MVR) became a routine operation, physiologic studies indicated that the continuity of mitral leaflets with papillary muscles, chordae tendineae (CT) and the atrioventricular ring may play a decisive role in the function of the left ventricle (LV) [1]. This led Lillehei et al. [2] to establish a procedure whereby the posterior leaflet, its CT and papillary muscles were preserved in MVRs. These and other studies indicated a significant reduction of postoperative mortality compared to conventional MVR. Though developed in the early 1960s by Lillehei, the technique of chordal preservation was not initially accepted. It wasn’t until 1983 that surgeons began to revive the concept of MVR with preservation of the CT. As this technique became more widely known, many clinical studies were performed; however, very few have been conducted which examine the effect of leaflets and CT on flow dynamics.

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