Key result
Application of a large patch to displace the posterior papillary muscle in ex vivo ovine hearts significantly increased mitral regurgitation flow by 554 mL/min compared to baseline (P=0.016).
Why the study?
Does outward displacement of the posterior papillary muscle using patches induce functional mitral regurgitation in an ex vivo ovine heart model?
Does outward displacement of the posterior papillary muscle using patches induce functional mitral regurgitation in an ex vivo ovine heart model?
p-value: p=0.016
An ex vivo pulsatile ovine heart model using a large patch to displace the posterior papillary muscle successfully reproduces functional mitral regurgitation, offering a platform for developing new surgical techniques.
Supports papillary muscle displacement as contributor to mitral regurgitation; leaves open relevance to human disease and surgical strategies.
BACKGROUND: Surgical method of choice for functional mitral regurgitation (FMR) is debatable, since recurrence of FMR post-annuloplasty has been reported in a significant number of cases. Developing a pulsatile FMR heart model by left ventricular dilatation can be a favorable option for usage in the primary stages of developing new surgical techniques that adjunctively targets the posterior papillary muscle (PPM) geometry. METHODS: PPM of ex vivo ovine hearts (N = 22) was displaced by three different sizes of patches to induce left ventricular dilatation and FMR. Mitral regurgitation (MR) flow, left ventricular and annular geometry were measured from the dynamic pulsatile flow system before and after patch placement. RESULTS: Outward displacement of PPM was significantly increased in all patch sizes compared to baseline (P = .016, P = .031, and P = .008 from small to large patch, respectively). Left ventricular volume (LVV) significantly increased from 18.53 (15.01-26.03) mL at baseline to 27.5 (19.45-42.46) mL after large patch placement (P = .031). However, the small and medium patch groups did not show significant changes in the LVV after patch placement. MR significantly increased 554 (185-1,919.3) mL/min after applying the large patch compared to baseline (P = .016). There were no significant changes from baseline in MR flow after applying the small and medium patch. Application of the large patch produced the highest proportion of FMR heart models (87.5%, P = .031). CONCLUSION: The large patch ex vivo pulsatile heart model demonstrated outward displacement of the PPM and significantly produced MR flow. This ex vivo pulsatile heart model can be used to facilitate surgical techniques that targets the PPM displacement in FMR patients.
No takes yet. Share an insight, caveat, or question.
Kradangnga et al. (2018) studied Functional mitral regurgitation (n=22). Outward displacement of posterior papillary muscle using patches vs. Baseline was evaluated on Mitral regurgitation flow (p=0.016). Application of a large patch to displace the posterior papillary muscle in ex vivo ovine hearts significantly increased mitral regurgitation flow by 554 mL/min compared to baseline (P=0.016).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: