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The Annals of Thoracic Surgery, Vol 58, 931-943, Copyright © 1994 by The Society of Thoracic Surgeons
MR Moon, A DeAnda Jr, GT Daughters 2nd, NB Ingels Jr and DC Miller
During chordal-sparing mitral valve replacement (MVR), some recommend
anatomic reattachment of the anterior leaflet chordae to the anterior
annulus; others advocate shifting the chordae to the posterior annulus. To
compare the results of these techniques with those of conventional MVR
(total chordal excision), 21 dogs were studied 5 to 12 days after
implantation of tantalum markers to measure left ventricular volume and
geometry. One to 3 weeks later, animals underwent conventional MVR (n = 7)
or chordal-sparing MVR with either anterior chordal reattachment (n = 7) or
posterior transposition (n = 7). Contractility was assessed using
physiologic volume intercepts for end-systolic elastance, preload
recruitable stroke work, and the relationship of the maximum rate of change
of left ventricular pressure to the end-diastolic volume. The physiologic
intercept for end-systolic elastance did not change after anterior or
posterior MVR, but increased from 60 +/- 14 mL before MVR to 72 +/- 17 mL
with conventional MVR (p < 0.002), indicating impaired left ventricular
contractility. Similarly, the physiologic intercept for preload recruitable
stroke work and the relationship of the maximum rate of change of left
ventricular pressure to the end-diastolic volume increased 22% +/- 13% and
28% +/- 13%, respectively, after conventional MVR, but neither changed
after anterior or posterior MVR. Although the end-diastolic pressure-volume
relationship did not change with either chordal-sparing technique, its
slope increased 98% +/- 73% after conventional MVR (p < 0.008). Thus,
although chordal preservation maintained better systolic and diastolic
function, there was no substantial difference between the results of the
anterior and posterior chordal-sparing techniques in this model.
ARTICLES
Experimental evaluation of different chordal preservation methods during mitral valve replacement
Department of Cardiovascular and Thoracic Surgery, Stanford University School of Medicine, California 94305.
This article has been cited by other articles:
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 L. P. Dasi, P. Sucosky, and A. P. Yoganathan Letter by Dasi et al Regarding Article, "Effect of Chronotropy and Inotropy on Stitch Tension in the Edge-to-Edge Mitral Repair" Circulation, July 22, 2008; 118(4): e78 - e78. [Full Text] [PDF]
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 T. Athanasiou, A. Chow, C. Rao, O. Aziz, F. Siannis, A. Ali, A. Darzi, and F. Wells Preservation of the mitral valve apparatus: evidence synthesis and critical reappraisal of surgical techniques Eur. J. Cardiothorac. Surg., March 1, 2008; 33(3): 391 - 401. [Abstract] [Full Text] [PDF]
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R. G. Fuster, I. Rodriguez, V. Estevez, and A. Vazquez Reply to kiris et Al. Eur. J. Cardiothorac. Surg., November 1, 2007; 32(5): 821 - 822. [Full Text] [PDF]
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I. Kiris, S. Gulmen, E. Kuralay, and E. Ibrisim Does posterior transposition of anterior leaflet for complete chordal preservation during mitral valve replacement improve postoperative left ventricular performance? Eur. J. Cardiothorac. Surg., November 1, 2007; 32(5): 820 - 821. [Full Text] [PDF]
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 M. Smerup, J. Funder, C. Nyboe, C. Hoyer, T. F. Pedersen, L. Ribe, S. Ringgaard, W. Y. Kim, E. M. Pedersen, N. T. Andersen, et al. Strut chordal-sparing mitral valve replacement preserves long-term left ventricular shape and function in pigs J. Thorac. Cardiovasc. Surg., December 1, 2005; 130(6): 1675 - 1682. [Abstract] [Full Text] [PDF]
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T. A. Timek, J. R. Glasson, D. T. Lai, D. Liang, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller Annular Height-to-Commissural Width Ratio of Annulolasty Rings In Vivo Circulation, August 30, 2005; 112(9_suppl): I-423 - I-428. [Abstract] [Full Text] [PDF]
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F. A. Tibayan, F. Rodriguez, F. Langer, M. K. Zasio, L. Bailey, D. Liang, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller Annular or subvalvular approach to chronic ischemic mitral regurgitation? J. Thorac. Cardiovasc. Surg., June 1, 2005; 129(6): 1266 - 1275. [Abstract] [Full Text] [PDF]
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 A. Cheng, F. Langer, F. Rodriguez, J. C. Criscione, G. T. Daughters, D. C. Miller, and N. B. Ingels Jr. Transmural cardiac strains in the lateral wall of the ovine left ventricle Am J Physiol Heart Circ Physiol, April 1, 2005; 288(4): H1546 - H1556. [Abstract] [Full Text] [PDF]
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T. A. Timek, D. T. Lai, D. Liang, F. Tibayan, F. Langer, F. Rodriguez, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller Effects of Paracommissural Septal-Lateral Annular Cinching on Acute Ischemic Mitral Regurgitation Circulation, September 14, 2004; 110(11_suppl_1): II-79 - II-84. [Abstract] [Full Text] [PDF]
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F. A. Tibayan, F. Rodriguez, F. Langer, M. K. Zasio, L. Bailey, D. Liang, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller Does septal-lateral annular cinching work for chronic ischemic mitral regurgitation? J. Thorac. Cardiovasc. Surg., March 1, 2004; 127(3): 654 - 663. [Abstract] [Full Text] [PDF]
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J. J. Nigro, D. S. Schwartz, R. D. Bart, C. W. Bart, B. M. Lopez, M. J. Cunningham, M. L. Barr, R. M. Bremner, S. M. Haddy, W. J. Wells, et al. Neochordal repair of the posterior mitral leaflet J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 440 - 447. [Abstract] [Full Text] [PDF]
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T. A. Timek, G. R. Green, F. A. Tibayan, D. T. Lai, F. Rodriguez, D. Liang, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller Aorto-mitral annular dynamics Ann. Thorac. Surg., December 1, 2003; 76(6): 1944 - 1950. [Abstract] [Full Text] [PDF]
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T. A. Timek, D. T. Lai, P. Dagum, F. Tibayan, G. T. Daughters, D. Liang, G. J. Berry, D. C. Miller, and N. B. Ingels Jr. Ablation of mitral annular and leaflet muscle: effects on annular and leaflet dynamics Am J Physiol Heart Circ Physiol, October 1, 2003; 285(4): H1668 - H1674. [Abstract] [Full Text] [PDF]
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F. A. Tibayan, F. Rodriguez, M. K. Zasio, L. Bailey, D. Liang, G. T. Daughters, F. Langer, N. B. Ingels Jr, and D. C. Miller Geometric Distortions of the Mitral Valvular-Ventricular Complex in Chronic Ischemic Mitral Regurgitation Circulation, September 9, 2003; 108(90101): II-116 - 121. [Abstract] [Full Text] [PDF]
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F. A. Tibayan, F. Rodriguez, D. Liang, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller Paneth Suture Annuloplasty Abolishes Acute Ischemic Mitral Regurgitation but Preserves Annular and Leaflet Dynamics Circulation, September 9, 2003; 108(90101): II-128 - 133. [Abstract] [Full Text] [PDF]
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S. L. Nielsen, T. A. Timek, G. R. Green, P. Dagum, G. T. Daughters, J. M. Hasenkam, A. F. Bolger, N. B. Ingels, and D. C. Miller Influence of Anterior Mitral Leaflet Second-Order Chordae Tendineae on Left Ventricular Systolic Function Circulation, July 29, 2003; 108(4): 486 - 491. [Abstract] [Full Text] [PDF]
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T. A. Timek, D. T. Lai, F. Tibayan, D. Liang, G. T. Daughters, P. Dagum, M. K. Zasio, S. Lo, T. Hastie, N. B. Ingels Jr, et al. Ischemia in three left ventricular regions: Insights into the pathogenesis of acute ischemic mitral regurgitation J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(3): 559 - 569. [Abstract] [Full Text] [PDF]
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 J. I. Fann, N. B. Ingels Jr., and D. C. Miller Pathophysiology of Mitral Valve Disease Card. Surg. Adult, January 1, 2003; 2(2003): 901 - 931. [Full Text]
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D. T. Lai, T. A. Timek, F. A. Tibayan, G. R. Green, G. T. Daughters, D. Liang, N. B. Ingels Jr, and D. C. Miller The effects of mitral annuloplasty rings on mitral valve complex 3-D geometry during acute left ventricular ischemia Eur. J. Cardiothorac. Surg., November 1, 2002; 22(5): 808 - 816. [Abstract] [Full Text] [PDF]
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T. A. Timek, D. T. Lai, F. Tibayan, G. T. Daughters, D. Liang, P. Dagum, S. Lo, D. C. Miller, and N. B. Ingels Jr. Atrial contraction and mitral annular dynamics during acute left atrial and ventricular ischemia in sheep Am J Physiol Heart Circ Physiol, November 1, 2002; 283(5): H1929 - H1935. [Abstract] [Full Text] [PDF]
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T. A. Timek, D. T. Lai, F. Tibayan, D. Liang, F. Rodriguez, G. T. Daughters, P. Dagum, N. B. Ingels Jr, and C. Miller Annular Versus Subvalvular Approaches to Acute Ischemic Mitral Regurgitation Circulation, September 24, 2002; 106(12_suppl_1): I-27 - I-32. [Abstract] [Full Text] [PDF]
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T. A. Timek, P. Dagum, D. T. Lai, F. Tibayan, D. Liang, G. T. Daughters, M. Hayase, N. B. Ingels Jr, and D. C. Miller Will a Partial Posterior Annuloplasty Ring Prevent Acute Ischemic Mitral Regurgitation? Circulation, September 24, 2002; 106(12_suppl_1): I-33 - I-39. [Abstract] [Full Text] [PDF]
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T. A. Timek, D. T. Lai, F. A. Tibayan, P. Dagum, G. T. Daughters, D. Liang, N. B. Ingels Jr, and D. C. Miller Hemodynamic performance of an unstented xenograft mitral valve substitute J. Thorac. Cardiovasc. Surg., September 1, 2002; 124(3): 541 - 552. [Abstract] [Full Text] [PDF]
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F. A. Tibayan, D. T. M. Lai, T. A. Timek, P. Dagum, D. Liang, G. T. Daughters, N. B. Ingels, and D. C. Miller Alterations in left ventricular torsion in tachycardia-induced dilated cardiomyopathy J. Thorac. Cardiovasc. Surg., July 1, 2002; 124(1): 43 - 49. [Abstract] [Full Text] [PDF]
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T. A. Timek, D. T. Lai, F. Tibayan, D. Liang, G. T. Daughters, P. Dagum, N. B. Ingels Jr, and D. C. Miller Septal-lateral annular cinching abolishes acute ischemic mitral regurgitation J. Thorac. Cardiovasc. Surg., May 1, 2002; 123(5): 881 - 888. [Abstract] [Full Text] [PDF]
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P. Dagum, T. Timek, G. R. Green, G. T. Daughters, D. Liang, N. B. Ingels Jr, and D. C. Miller Three-dimensional geometric comparison of partial and complete flexible mitral annuloplasty rings J. Thorac. Cardiovasc. Surg., October 1, 2001; 122(4): 665 - 673. [Abstract] [Full Text] [PDF]
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T. A. Timek, P. Dagum, D. T. Lai, D. Liang, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller Pathogenesis of Mitral Regurgitation in Tachycardia-Induced Cardiomyopathy Circulation, September 18, 2001; 104(90001): I-47 - 53. [Abstract] [Full Text] [PDF]
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T. A. Timek, S. L. Nielsen, G. R. Green, P. Dagum, A. F. Bolger, G. T. Daughters, J. M. Hasenkam, N. B. Ingels Jr, and D. C. Miller Influence of anterior mitral leaflet second-order chordae on leaflet dynamics and valve competence Ann. Thorac. Surg., August 1, 2001; 72(2): 535 - 540. [Abstract] [Full Text] [PDF]
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T. A. Timek, S. L. Nielsen, D. Liang, D. T. Lai, P. Dagum, G. T. Daughters, N. B. Ingels Jr., and D. C. Miller Edge-to-edge mitral repair: gradients and three-dimensional annular dynamics in vivo during inotropic stimulation Eur. J. Cardiothorac. Surg., April 1, 2001; 19(4): 431 - 437. [Abstract] [Full Text] [PDF]
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D. T. M. Lai, T. A. Timek, P. Dagum, G. R. Green, J. R. Glasson, G. T. Daughters, D. Liang, N. B. Ingels Jr, and D. C. Miller The effects of ring annuloplasty on mitral leaflet geometry during acute left ventricular ischemia J. Thorac. Cardiovasc. Surg., November 1, 2000; 120(5): 966 - 975. [Abstract] [Full Text] [PDF]
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T. Timek, J. R. Glasson, P. Dagum, G. R. Green, J. F. Nistal, M. Komeda, G. T. Daughters, A. F. Bolger, L. E. Foppiano, N. B. Ingels Jr, et al. RING ANNULOPLASTY PREVENTS DELAYED LEAFLET COAPTATION AND MITRAL REGURGITATION DURING ACUTE LEFT VENTRICULAR ISCHEMIA J. Thorac. Cardiovasc. Surg., April 1, 2000; 119(4): 774 - 783. [Abstract] [Full Text] [PDF]
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G. R. Green, P. Dagum, J. R. Glasson, G. T. Daughters, A. F. Bolger, L. E. Foppiano, G. J. Berry, N. B. Ingels Jr, and D. C. Miller Mitral Annular Dilatation and Papillary Muscle Dislocation Without Mitral Regurgitation in Sheep Circulation, November 9, 1999; 100(90002): II-95 - 102. [Abstract] [Full Text] [PDF]
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M. R. Moon, A. DeAnda Jr, G. T. Daughters II, N. B. Ingels Jr, and D. C. Miller Effects of mitral valve replacement on regional left ventricular systolic strain Ann. Thorac. Surg., September 1, 1999; 68(3): 894 - 902. [Abstract] [Full Text] [PDF]
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P. Dagum, G. R. Green, J. R. Glasson, G. T. Daughters, A. F. Bolger, L. E. Foppiano, N. B. Ingels Jr, and D. C. Miller POTENTIAL MECHANISM OF LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION AFTER MITRAL RING ANNULOPLASTY J. Thorac. Cardiovasc. Surg., March 1, 1999; 117(3): 472 - 480. [Abstract] [Full Text] [PDF]
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J. S. Lawton, P.-W. Hsia, and R. J. Damiano Jr The adenosine-triphosphate-sensitive potassium-channel opener pinacidil is effective in blood cardioplegia Ann. Thorac. Surg., September 1, 1998; 66(3): 768 - 773. [Abstract] [Full Text] [PDF]
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M. Jayawant, E. R. Stephenson Jr., and R. J. Damiano Jr. Advantages of continuous hyperpolarized arrest with pinacidil over St. Thomas' hospital solution during prolonged ischemia J. Thorac. Cardiovasc. Surg., July 1, 1998; 116(1): 131 - 138. [Abstract] [Full Text]
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J. S. Lawton, P.-W. Hsia, C. T. Allen, and R. J. Damiano Jr. MYOCARDIAL PROTECTION IN THE ACUTELY INJURED HEART: HYPERPOLARIZING VERSUS DEPOLARIZING HYPOTHERMIC CARDIOPLEGIA J. Thorac. Cardiovasc. Surg., March 1, 1997; 113(3): 567 - 575. [Abstract] [Full Text]
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J. S. Lawton, J. D. Sepic, C. T. Allen, P.-W. Hsia, and R. J. Damiano Jr Myocardial Protection With Potassium-Channel Openers Is as Effective as St. Thomas' Solution in the Rabbit Heart Ann. Thorac. Surg., July 1, 1996; 62(1): 31 - 38. [Abstract] [Full Text]
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J. S. Lawton, G. C. Harrington, C. T. Allen, P.-W. Hsia, and R. J. Damiano Jr Myocardial Protection With Pinacidil Cardioplegia in the Blood-Perfused Heart Ann. Thorac. Surg., June 1, 1996; 61(6): 1680 - 1688. [Abstract] [Full Text]
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M. Natsuaki, T. Itoh, S. Tomita, K. Furukawa, M. Yoshikai, H. Suda, and H. Ohteki Importance of Preserving the Mitral Subvalvular Apparatus in Mitral Valve Replacement Ann. Thorac. Surg., February 1, 1996; 61(2): 585 - 590. [Abstract] [Full Text]
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M. Komeda, A. DeAnda Jr, J. R. Glasson, A. F. Bolger, Y. Tomizawa, G. T. Daughters II, T. L. Tye, N. B. Ingels Jr, and D. C. Miller Exploring Better Methods to Preserve the Chordae Tendineae During Mitral Valve Replacement Ann. Thorac. Surg., December 1, 1995; 60(6): 1652 - 1658. [Abstract] [Full Text]
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A. DeAnda Jr, M. Komeda, S. D. Nikolic, G. T. Daughters II, N. B. Ingels, and D. C. Miller Left Ventricular Function, Twist, and Recoil After Mitral Valve Replacement Circulation, November 1, 1995; 92(9): 458 - 466. [Abstract] [Full Text]
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S. Miki Mitral Valve Replacement With Preservation of Chordae Tendineae and Papillary Muscles Ann. Thorac. Surg., July 1, 1995; 60(1): 225 - 226. [Full Text]
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T. J. Vander Salm, L. A. Pape, and J. F. Mauser Mitral Valve Replacement With Complete Retention of Native Leaflets Ann. Thorac. Surg., January 1, 1995; 59(1): 52 - 55. [Abstract] [Full Text]
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