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Ann Thorac Surg 1989;47:872-876
© 1989 The Society of Thoracic Surgeons

Articles

Mitral valve function after cryoablation of the posterior papillary muscle in the dog

Gerard M. Guiraudon, MD, FRCS(C), Colette M. Guiraudon, MD, FRCS(C)*, Douglas G. McLellan, BSc, MA, James L. MacDonald, CCP

Surgical Laboratory for Cardiac Arrhythmia, Departments of Surgery and Pathology, University of Western Ontario, University Hospital, London, Ontario, Canada

Accepted for publication December 19, 1988.

* Address reprint requests to Dr Guiraudon, University Hospital, 339 Windermere Rd, London, Ontario, Canada N6A 5A5.

Extensive cryoablation of an arrhythmogenic left ventricular posterior papillary muscle associated with ventricular arrhythmias may affect mitral valve function. We studied the long-term effects of extensive cryoablation of the posterior papillary muscle and its ventricular attachment in 10 dogs. The dogs had hemodynamic, electrophysiological, and angiographic testing 1 month after operation. Seven dogs were then killed, and the hearts were examined at that time. Three dogs had repeat assessments 2 and 3 months after operation before they were killed. At 1 month, left ventricular angiography showed normal mitral valve function in all dogs. Pathological examination revealed that the posterior papillary muscle and its left ventricular attachment were replaced by a discrete dense, fibrous scar. The fibrous process involved the mitral valve in 2 dogs. At 3 months, pathological examination showed a marked fibrous scar with chondroid metaplasia and fibrous involvement of the mitral valve chordae and posterior leaflet in all 3 dogs. We conclude that extensive cryoablation of the posterior papillary muscle is not associated with long-term mitral valve dysfunction, and may be the best surgical technique to ablate an arrhythmogenic papillary muscle.






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