1988
DOI: 10.1055/s-2007-1022972 View full text |Buy / Rent full text
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Abstract: The hemodynamic effects of acute mitral regurgitation (MR) were investigated using a newly designed adjustable mitral ring prosthesis with remote control mechanism, implanted in mongrel dogs. The prosthesis allows to dilate the mitral annulus from outside the beating heart, and to create reversible MR of any desired degree without injuring the mitral valve apparatus. Dilatation of the mitral annulus by 25% of its circumference led to MR of angiographic grade 3+. Left ventricular systolic pressure (LVSP) droppe… Show more

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“…3,16 Annular dilatation alone has been suggested to result in MR in cardiomyopathy, 5 and an isolated increase of annular perimeter by 25% with an externally adjustable ring has been shown to cause moderate-to-severe MR in experimental animals. 17 Furthermore, similar annular perimeter increase, as seen in the present study, has been reported to result in incomplete mitral leaflet coaptation in a finite element analysis of mitral dilatation in a computational model. 18 Thus TIC led to annular area and perimeter changes consistent with the development of MR.…”
Section: Discussionsupporting
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“…3,16 Annular dilatation alone has been suggested to result in MR in cardiomyopathy, 5 and an isolated increase of annular perimeter by 25% with an externally adjustable ring has been shown to cause moderate-to-severe MR in experimental animals. 17 Furthermore, similar annular perimeter increase, as seen in the present study, has been reported to result in incomplete mitral leaflet coaptation in a finite element analysis of mitral dilatation in a computational model. 18 Thus TIC led to annular area and perimeter changes consistent with the development of MR.…”
Section: Discussionsupporting
“…We confirmed that mitral surgery and previous LVEF < 50% were associated with post-operative RVF, as already described previously, with a high incidence of low cardiac output state after mitral valve procedures (23,24). The principal mechanism invoked is an abrupt increase in afterload due to elimination of the reverse flow into the left atrium, all the more so if LV was decreased before correction (25,26).…”
Section: Discussionsupporting
“…As the timing of the regurgitant jet could not be determined, no concrete cause-and-effect relationship between delayed leaflet coaptation and regurgitation was possible. A canine experiment showed that an isolated 25% increase in mitral annular circumference with an externally adjustable rigid mitral ring resulted in 3+ MR, 23 which resolved when the ring was reduced to its original size. This increase in annular dimension would result in a greater increase in area than that observed in our study but illustrates that MR can result from annular dilatation alone.…”
Section: Discussionmentioning