Effects of chordal disruption on regional left ventricular torsional deformation

Marc R. Moon, Abelardo DeAnda, George T. Daughters, Neil B. Ingels, D. Craig Miller

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Chordal excision during mitral valve replacement (MVR) impairs left ventricular (LV) systolic function, but the mechanisms responsible for this change remain unclear. This study was performed to determine the influence of annular-papillary continuity on regional LV torsional deformation acutely following MVR with and without chordal preservation. Methods and Results: Twenty-seven dogs underwent placement of LV subepicardial myocardial markers to measure regional LV systolic torsional deformation throughout the left ventricle. After 1 week, biplane fluoroscopic marker images were obtained pre-MVR in the baseline state and with inotropic stimulation (calcium, 15 mg/kg). Dogs were then randomized to undergo a sham procedure with cardiopulmonary bypass but no valve replacement (n = 6), conventional MVR with chordal excision (n=7), or chordal sparing MVR with preservation of the posterior leaflet and reattachment of the anterior leaflet chordae to either the anterior annulus (n=7) or posterior annulus (n=7). After chest closure and recovery from anesthesia, post MVR data were acquired. At the LV apical level, maximal regional LV systolic torsional deformation (θ(max)) did not fall from pre-MVR values in the baseline state after the sham procedure or anterior or posterior chordal-sparing MVR procedure (P≤.10). After conventional MVR, baseline θ(max) fell by 66% to 81% in the anteroseptal, anterior, anterolateral, and lateral regions (P

Original languageEnglish (US)
JournalCirculation
Volume94
Issue number9 SUPPL.
StatePublished - Nov 1 1996
Externally publishedYes

Fingerprint

Mitral Valve
Dogs
Cardiopulmonary Bypass
Left Ventricular Function
Heart Ventricles
Thorax
Anesthesia
Calcium

Keywords

  • dynamics
  • mitral valve
  • surgery

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Moon, M. R., DeAnda, A., Daughters, G. T., Ingels, N. B., & Miller, D. C. (1996). Effects of chordal disruption on regional left ventricular torsional deformation. Circulation, 94(9 SUPPL.).

Effects of chordal disruption on regional left ventricular torsional deformation. / Moon, Marc R.; DeAnda, Abelardo; Daughters, George T.; Ingels, Neil B.; Miller, D. Craig.

In: Circulation, Vol. 94, No. 9 SUPPL., 01.11.1996.

Research output: Contribution to journalArticle

Moon, MR, DeAnda, A, Daughters, GT, Ingels, NB & Miller, DC 1996, 'Effects of chordal disruption on regional left ventricular torsional deformation', Circulation, vol. 94, no. 9 SUPPL..
Moon MR, DeAnda A, Daughters GT, Ingels NB, Miller DC. Effects of chordal disruption on regional left ventricular torsional deformation. Circulation. 1996 Nov 1;94(9 SUPPL.).
Moon, Marc R. ; DeAnda, Abelardo ; Daughters, George T. ; Ingels, Neil B. ; Miller, D. Craig. / Effects of chordal disruption on regional left ventricular torsional deformation. In: Circulation. 1996 ; Vol. 94, No. 9 SUPPL.
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