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document
Late hemodynamic effects of the preserved papillary muscles during mitral valve replacement . BACKGROUND The late hemodynamic effects of preserving the papillary muscles during mitral valve replacement have not been evaluated . METHODS AND RESULTS Sixteen patients who had chronic mitral regurgitation due to myxomatous degeneration were randomized to preservation ( Pres group , n = 8 ) or no preservation ( No Pres group , n = 8 ) of the chordae tendineae and papillary muscles during mitral valve replacement . Rest and exercise nuclear ventriculograms were performed early ( 3 months ) and late ( 5 years ) after surgery . Early after surgery , the No Pres group had lower ejection fractions and stroke work indexes ( P < .05 by repeated-measures [ rm ] ANOVA ) than the Pres group did at similar end-diastolic volume indexes . The No Pres group had similar cardiac indexes after exercise because heart rate increased ( P < .005 by rm ANOVA ) . Late after surgery , ejection fraction was greater at similar end-diastolic volume indexes ( P < .005 by rm ANCOVA ) , and preload recruitable stroke work indexes ( P < .001 by rm ANCOVA ) were better in the Pres group . CONCLUSIONS Preserving chordal attachments enhanced the late hemodynamic recovery after mitral valve replacement for mitral regurgitation .
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Intervention_Surgical
mitral valve replacement
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Intervention_Physical
preservation
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Intervention_Control
no preservation
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Intervention_Surgical
of the chordae tendineae and papillary muscles during mitral valve replacement
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Intervention_Physical
Rest and exercise nuclear ventriculograms
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Outcome_Physical
lower ejection fractions
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Outcome_Physical
stroke work indexes
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Outcome_Physical
cardiac indexes
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Outcome_Physical
heart rate increased
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Outcome_Physical
ejection fraction
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Outcome_Physical
end-diastolic volume indexes
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Outcome_Physical
preload recruitable stroke work indexes
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Participant_Condition
mitral valve replacement .
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Participant_Sample-size
Sixteen
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Participant_Condition
chronic mitral regurgitation due to myxomatous degeneration
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Participant_Condition
preservation
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Participant_Sample-size
8
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Participant_Condition
no preservation
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Participant_Sample-size
8