Skip to main content
SpringerLink
Log in

Current concepts in the pathogenesis and treatment of ischemic mitral regurgitation

  • Conference paper
Ischemic Mitral Incompetence

Abstract

Under normal conditions, mitral valve competence is maintained by a complex interaction of the five components of mitral valve function: the ventricular wall, the fibrous annulus, the papillary muscles, the chordae tendineae, and the valve leaflets. Derangements in any single component can produce valve dysfunction, but in ischemic incompetence, the primary defect is infarction of the ventricular wall and papillary muscles. With increasing interest in valvular reconstruction in ischemic mitral regurgitation, a detailed knowledge of mitral valve anatomy has become essential.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Van Mierop LHS (1979) Morphologic development of the heart. In: Berne RM, Sperelakis N, Geiger SR, (eds) Handbook of Physiology, Section 2: The cardiovascular system. American Physiological Society, Bethesda, Maryland

    Google Scholar 

  2. Roberts WC, Perloff JK (1972) Mitral valvular disease: A clinicopathologic survey of the conditions causing the mitral valve to function abnormally. Ann Int Med 77:939

    PubMed  CAS  Google Scholar 

  3. Glover RP, Davilla JC (1961) The surgery of mitral stenosis. Grune and Stratton, New York

    Google Scholar 

  4. Roberts WC (1983) Morphologic features of the normal and abnormal mitral valve. Am J Cardiol 51:1005

    Article  PubMed  CAS  Google Scholar 

  5. Ellis FH Jr. (1967) Surgery for acquired mitral valve disease. Saunders and Company, Philadelphia

    Google Scholar 

  6. Perloff JK, Roberts WC (1984) The mitral apparatus: Functional anatomy of mitral regurgitation. J Thorac Cardiovasc Surg 88:663

    Google Scholar 

  7. Dalen JE, Alberts JS (1981) Valvular heart disease. Little, Brown, and Company, Boston

    Google Scholar 

  8. Yellin EL, Yoran C, Frater RWM (1984) Physiology of mitral valve flow. Chapter 4. In: Duran C, Angell WW, Johnson AD, Oury JH (eds) Recent Progress in Mitral Valve Disease. Butter-worths, London

    Google Scholar 

  9. Yellin EL, Masatsugu H, Yoran C, Sonnenblick EH, Gabbay S, Frater RWM (1986) Left ventricular relaxation in the filling and nonfilling intact heart. Am J Physiol 250:H620

    Google Scholar 

  10. Bellhouse BJ (1972) The fluid mechanics of heart valves. Chapter 8. In: Bergel DH (ed) Cardiovascular fluid dynamics. Academic Press, London New York

    Google Scholar 

  11. Weiting DW, Stripling TE (1984) Dynamics and fluid dynamics of the mitral valve. In: Duran D, Angell WW, Johnson AD, Oury JH (eds) Recent progress in mitral valve disease. Butter-worths, London

    Google Scholar 

  12. Shah PM, Tei C (1984) Functional anatomy of the mitral valve and annulus in man: Lessons from echocardiographic observations. Chapter 6. In: Duran C, Angell WW, Johnson AD, Oury JH (eds) Recent progress in mitral valve disease. Butterworths, London

    Google Scholar 

  13. Hagl S, Heimisch W, Meisner H, Mendier N, Sebening F (1984) In-situ function of the papillary muscles in the intact canine left ventricle. Chapter 32. In: Duran C, Angell WW, Johnson AD, Oury JH (eds) Recent progress in mitral valve disease. Butterworths, London

    Google Scholar 

  14. Rankin JS, Feneley MP, Hickey MStJ, Muhlbaier LH, et al. (1988) A clinical comparison of mitral valve repair versus valve replacement in ischemic mitral regurgitation. J Thorac Car-diovasc Surg 95:165

    CAS  Google Scholar 

  15. Hickey MSJ, Smith LR, Muhlbaier LH, Harreil F Jr, Reves JG, Hinohara T, Califf RM, Pryor DB, Rankin JS (1988) Current prognosis of ischemic mitral regurgitation: Implications for future management. Circulation [Suppl I] 78:1–51

    Google Scholar 

  16. Rankin JS, Hickey MStJ, Smith LR, deBruijn NP, Clements FM, Muhlbaier LH, Lowe JE, Wechsler AS, Califf RM, Reves JG, Wolfe WG (1988) Current management of mitral valve incompetence associated with coronary artery disease. J Cardiac Surg (in press)

    Google Scholar 

  17. DiSesa VJ, Cohn LH, Collins JJ Jr, Koster JK, VanDevanter S (1982) Determinants of operative survival following combined mitral valve replacement and coronary revascularization. Ann Thorac Surg 34:484

    Article  Google Scholar 

  18. Tepe NA, Edmunds LH Jr (1985) Operation for acute postinfarction mitral insufficiency and cardiogenic shock. J Thorac Cardiovasc Surg 89:525

    PubMed  CAS  Google Scholar 

  19. Gerbode FLA, Hetzer R, Krebber HJ (1978) Surgical management of papillary muscle rupture due to myocardial infarction. World J Surg 2:791

    Article  PubMed  CAS  Google Scholar 

  20. Merin G, Giulani ER, Pluth JR, Wallace RB, Danielson GK (1973) Surgery for mitral valve incompetence after myocardial infarction. Am J Cardiol 32:322

    Article  PubMed  CAS  Google Scholar 

  21. Killen DA, Reed WA, Wathanacharoen S, Beauchamp G, Rutherford B (1983) Surgical treatment of papillary muscle rupture. Ann Thorac Surg 35:243

    Article  PubMed  CAS  Google Scholar 

  22. Clements SD, Story WE, Hurst JW, Craver JM, Jones EL (1985) Ruptured papillary muscle, a complication of myocardial infarction: Clinical presentation, diagnosis, and treatment. Clin Cardiol 8:93

    Article  PubMed  Google Scholar 

  23. Nishimura RA, Schaff HV, Shub C, Gersh BJ, Edwards WD, Tajik AJ (1983) Papillary muscle rupture complicating acute myocardial infraction: Analysis of 17 patients. Am J Cardiol 51:373

    Article  PubMed  CAS  Google Scholar 

  24. Gula G, Yacoub MH (1981) Surgical correction of complete rupture of the anterior papillary muscle. Ann Thorac Surg 32:88

    Article  PubMed  CAS  Google Scholar 

  25. Carpentier A, Didier L, Deloche A, Perier P (1987) Surgical anatomy and management of ischemic mitral valve incompetence. Circulation 76 [Suppl IV]: 1776

    Google Scholar 

  26. Cosgrove DM (1987) Valve reconstruction versus valve replacement. In: Crawford FA Jr (ed) Cardiac surgery: Current heart valve prostheses. Cardiac Surgery: State of the Art Reviews, Vol. 1, No. 2. Hanley & Belfus, Philadelphia

    Google Scholar 

  27. Najafi H, Hushang J, Hunter JA, Goldin MD, Serry C, Dye WS (1975): Mitral insufficiency secondary to coronary heart disease. Ann Thorac Surg 20:529

    Article  PubMed  CAS  Google Scholar 

  28. Radford MJ, Johnson RA, Buckley MJ, Daggett WM, Leinbach RC, Gold HK (1979) Survival following mitral valve replacement for mitral regurgitation due to coronary artery disease. Circulation 60 [Suppl I]:I-39

    Google Scholar 

  29. Reinfeld HB, Samet P, Hildner FJ (1985) Resolution of congestive failure, mitral regurgitation, and angina after percutaneous transluminal coronary angioplasty of triple vessel disease. Cath Cardiovasc Diagn 11:273

    Article  CAS  Google Scholar 

  30. Heuser RR, Maddoux GL, Goss JE, Ramo BW, Raff GL, Shadoff N (1987) Coronary angioplasty for acute mitral regurgitation due to myocardial infarction. Ann Int Med 107:852

    PubMed  CAS  Google Scholar 

  31. Kay GL, Kay JH, Zubiate P, Yokoyama T, Mendez M (1986) Mitral valve repair for mitral regurgitation secondary to coronary artery disease. Circulation 74 [Suppl I]:I-88

    Google Scholar 

  32. Connolly MW, Gelbfish JS, Jacobwitz IJ, Rose DM, Mendelsohn A, Cappabianca PM, Acinapura AJ, Cunningham JN Jr (1986) Surgical results for mitral regurgitation from coronary artery disease. J Thorac Cardiovasc Surg 91:379

    PubMed  CAS  Google Scholar 

  33. Rokey R, Sterling LL, Zoghbi WA, Sartori MP, Limacher MC, Kuo LC, Quinones MA (1986) Determination of regurgitant fraction in isolated mitral or aortic regurgitation by pulsed Doppler two-dimensional echocardiography. J Am Coll Cardiol 7:1273

    Article  PubMed  CAS  Google Scholar 

  34. Lopez JF, Hanson S, Orchard RC, Tan L (1985) Quantification of mitral valvular incompetence. Cath Cardiovasc Diag 11:39

    Article  Google Scholar 

  35. Lell WA, Reves JG, Samuelson PN (1986) Anesthesia for cardiac surgery. In: Kirklin JW (ed) Cardiac surgery. Wiley Medical Publishers, New York, pp 109–138

    Google Scholar 

  36. DeBruijn NP, Clements FM, Kisslo JA (1987) Applications of color flow imaging. Echocardiography 4:557

    Article  Google Scholar 

  37. Sheikh KH, deBruijn N, Rankin JS, Stanley T, Clements F, Wolfe W, Kisslo J (1989) Utility of transesophageal echocardiography in patients undergoing cardiac valve surgery. J Am Coll Cardiol (in press)

    Google Scholar 

  38. Rankin JS, Sabiston DC Jr (1989) Physiology of the coronary circulation, myocardial function, and intraoperative myocardial protection. In: Sabiston DC Jr, Spencer FC (eds) Gibbon’s surgery of the chest. Saunders, Philadelphia

    Google Scholar 

  39. Rankin JS, Newman GE, Bashore TN, Muhlbaier LH, Tyson GS, Ferguson TB Jr, Sabiston DC Jr (1986) Clinical and angiographic assessment of complex mammary artery bypass grafting. J Thorac Cardiovasc Surg 92:832

    PubMed  CAS  Google Scholar 

  40. Wooler GH, Nixon PG, Grimshaw VA, Watson DA (1962) Experience with the repair of the mitral valve in mitral incompetence. Thorax 17:49

    Article  PubMed  CAS  Google Scholar 

  41. Reed GE, Pooley RW, Moggio RA (1980) Durability of measured mitral annuloplasty-se-venteen year study. J Thorac Cardiovasc Surg 79:321

    PubMed  CAS  Google Scholar 

  42. Johnson WD, Pedraza PM, Kayser KL (1984) Preservation and restoration of the mitral mechanism during inferior wall aneurysmectomy. In: Duran CMG, Angell WW, Johnson AD, Oury JH (eds) Recent progress in mitral valve disease, Butterworths, London

    Google Scholar 

  43. Rankin JS, Newman GE, Muhlbaier LH, Behar VS, Fedor JM, Sabiston DC Jr (1985) The effects of coronary revascularization on left ventricular function in ischemic heart disease. J Thorac Cardiovasc Surg 90:818

    PubMed  CAS  Google Scholar 

  44. Carpentier A (1983) Cardiac valve surgery — the “French correction”. J Thorac Cardiovasc Surg 86:323

    PubMed  CAS  Google Scholar 

  45. Lessana A, Escorsin M, Romano M, Andes F, Vergoni W, Lorenzoni D, Menozzi C, Mon-ducci I (1985) Transposition of posterior leaflet for treatment of ruptured main chordae of the anterior mitral leaflet. J Thorac Cardiovasc Surg 89:804

    PubMed  CAS  Google Scholar 

  46. Dawkins K, Paneth M (1986) Mitral repair versus replacement [letter]. J Thorac Cardiovasc Surg 91:150

    PubMed  CAS  Google Scholar 

  47. Bonchek LI, Olinger GN, Siegel R, Trensch DD, Keelan MH Jr (1984) Left ventricular performance after mitral reconstruction for mitral regurgitation. J Thorac Cardiovasc Surg 88:122

    PubMed  CAS  Google Scholar 

  48. Hansen DE, Cahill PD, Derby GC, Miller DC (1987) Relative contributions of the anterior and posterior mitral chordae tendineae to canine global left ventricular systolic function. J Thorac Cardiovasc Surg 93:45

    PubMed  CAS  Google Scholar 

  49. David TE, Ho WC (1986) The effect of preservation of chordae tendineae on mitral valve replacement for postinfarction mitral regurgitation. Circulation 74 [Suppl I]:I—116

    Google Scholar 

  50. David TE (1986) Mitral valve replacement with preservation of chordae tendineae: rationale and technical considerations. Ann Thorac Surg 41:680

    Article  PubMed  CAS  Google Scholar 

  51. Cooley DA, Ingram MT (1987) Intravalvular implantation of mitral valve prostheses. Tex Heart Inst J 14:188

    PubMed  CAS  Google Scholar 

  52. Come PC, Riley MF, Weintraub RM, Wei JY, Markis JE, Lorell BH (1987) Dynamic left ventricular outflow tract obstruction when the anterior leaflet is retained at prosthetic mitral valve replacement. Ann Thorac Surg 43:561

    Article  PubMed  CAS  Google Scholar 

  53. Harpole DH, Rankin JS, Wolfe WG, Smith LR, Young WR, Clements FM, Jones RH: Assessment of left ventricular functional preservation during isolated cardiac valvular operations. Circulation 80 (SupplIII): (Inpress)

    Google Scholar 

  54. Cohn LH: The surgical treatment of valvular heart disease. In: Gay WA Jr (ed), Cardiovascular surgery, Chapter 18 Harper & Row, Philadelphia

    Google Scholar 

  55. Spencer FC, Galloway AC, Colvin SB (1985) A clinical evaluation of the hypothesis that rupture of the left ventricle following mitral valve replacement can be prevented by preservation of the chordae of the mural leaflet. Ann Surg 202:673

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Surgery, Medicine, and Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA

    J. Scott Rankin M.D., M. S. J. Hickey, L. R. Smith, N. P. DeBruijn, K. H. Sheikh & D. C. Sabiston Jr.

  2. Department of Surgery, Duke University Medical Center, Box 38 51, Durham, North Carolina, 27710, USA

    J. Scott Rankin M.D.

Authors
  1. J. Scott Rankin M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. S. J. Hickey
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. R. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N. P. DeBruijn
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. H. Sheikh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. D. C. Sabiston Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Klinikum Großhadern, Ludwig-Maximilians-Universität, Marchioninistraße 15, 8000, München 70, Germany

    H. O. Vetter

  2. Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 1000, Berlin 65, Germany

    R. Hetzer

  3. Universitätsklinikum Rudolf Virchow, Freie Universität Berlin, Spanndauer Damm 130, 1000, Berlin 19, Germany

    H. Schmutzler

Rights and permissions

Reprints and permissions

Copyright information

© 1991 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Rankin, J.S., Hickey, M.S.J., Smith, L.R., DeBruijn, N.P., Sheikh, K.H., Sabiston, D.C. (1991). Current concepts in the pathogenesis and treatment of ischemic mitral regurgitation. In: Vetter, H.O., Hetzer, R., Schmutzler, H. (eds) Ischemic Mitral Incompetence. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-662-08027-6_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-08027-6_14

  • Publisher Name: Steinkopff, Heidelberg

  • Print ISBN: 978-3-662-08029-0

  • Online ISBN: 978-3-662-08027-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation