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Effects of standard mitral valve replacement on left ventricular function.

Publication ,  Journal Article
Harpole, DH; Rankin, JS; Wolfe, WG; Clements, FM; Van Trigt, P; Young, WG; Jones, RH
Published in: Ann Thorac Surg
June 1990

Recent studies have suggested that excision of the mitral valve apparatus during mitral valve replacement impairs left ventricular performance. However, functional measurements in humans have been difficult to obtain in a load-independent fashion. To investigate this concept, 12 patients (mean age, 65 +/- 8 years; mean New York Heart Association functional class, 3.3 +/- 0.7) with 4+ mitral regurgitation (n = 8) or mitral stenosis (valve area, 1.2 +/- 0.2 cm2) (n = 4) underwent prosthetic valve replacement using crystalloid cardioplegia. No patient required therapeutic inotropic support, every patient had at least the anterior mitral leaflet excised, and paced heart rate was maintained constant throughout. Left ventricular volume was measured with radionuclide angiocardiography, left ventricular pressure with a 3F micromanometer, and left ventricular wall volume with two-dimensional transesophageal echocardiography. Left ventricular preload was varied over a mean end-diastolic pressure range of 9 to 20 mm Hg and an end-diastolic volume range of 134 to 170 mL to generate four to five steady-state pressure-volume loops before and ten minutes after cardiopulmonary bypass. Left ventricular performance was estimated with the stroke work/end-diastolic volume relationship, which is insensitive to load. After bypass, no significant change (p greater than 0.1) was noted in wall volume for patients with mitral regurgitation or mitral stenosis (175 +/- 68 to 189 +/- 63 mL/m2 and 130 +/- 22 to 127 +/- 19 mL/m2, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Duke Scholars

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

June 1990

Volume

49

Issue

6

Start / End Page

866 / 873

Location

Netherlands

Related Subject Headings

  • Stroke Volume
  • Respiratory System
  • Radionuclide Ventriculography
  • Myocardial Contraction
  • Mitral Valve Stenosis
  • Mitral Valve Insufficiency
  • Mitral Valve
  • Male
  • Humans
  • Heart Valve Prosthesis
 

Citation

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Harpole, D. H., Rankin, J. S., Wolfe, W. G., Clements, F. M., Van Trigt, P., Young, W. G., & Jones, R. H. (1990). Effects of standard mitral valve replacement on left ventricular function. Ann Thorac Surg, 49(6), 866–873. https://doi.org/10.1016/0003-4975(90)90858-4
Harpole, D. H., J. S. Rankin, W. G. Wolfe, F. M. Clements, P. Van Trigt, W. G. Young, and R. H. Jones. “Effects of standard mitral valve replacement on left ventricular function.Ann Thorac Surg 49, no. 6 (June 1990): 866–73. https://doi.org/10.1016/0003-4975(90)90858-4.
Harpole DH, Rankin JS, Wolfe WG, Clements FM, Van Trigt P, Young WG, et al. Effects of standard mitral valve replacement on left ventricular function. Ann Thorac Surg. 1990 Jun;49(6):866–73.
Harpole, D. H., et al. “Effects of standard mitral valve replacement on left ventricular function.Ann Thorac Surg, vol. 49, no. 6, June 1990, pp. 866–73. Pubmed, doi:10.1016/0003-4975(90)90858-4.
Harpole DH, Rankin JS, Wolfe WG, Clements FM, Van Trigt P, Young WG, Jones RH. Effects of standard mitral valve replacement on left ventricular function. Ann Thorac Surg. 1990 Jun;49(6):866–873.
Journal cover image

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

June 1990

Volume

49

Issue

6

Start / End Page

866 / 873

Location

Netherlands

Related Subject Headings

  • Stroke Volume
  • Respiratory System
  • Radionuclide Ventriculography
  • Myocardial Contraction
  • Mitral Valve Stenosis
  • Mitral Valve Insufficiency
  • Mitral Valve
  • Male
  • Humans
  • Heart Valve Prosthesis