Relief of Mitral Leaflet Tethering Following Chronic Myocardial Infarction by Chordal Cutting Diminishes Left Ventricular Remodeling

Messas, Emmanuel; Bel, Alain; Szymanski, Catherine; Cohen, Isabelle; Touchot, B; Handschumacher, Mark D.; Desnos, Michel; Carpentier, Alain; Menasché, Philippe; Hagège, Albert; Levine, Robert A.

doi:10.1161/circimaging.109.931840

Cited by 36 publications

(20 citation statements)

References 49 publications

(44 reference statements)

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“…The same investigators confirmed these results in an additional report. 19 The first clinical reports appeared in 2005 from Yamamoto and colleagues 20 and Fayad and colleagues, 8 with good results and no reduction in LV function after a follow-up of 6 months and 2 years, respectively. Furthermore, Fayad and colleagues 8 proposed that aortotomy could be the best surgical approach for CC, because of the optimal access to the ventricular side of the AL.…”

Section: Discussionmentioning

confidence: 99%

Chordal cutting in ischemic mitral regurgitation: A propensity-matched study

Calafiore

Refaie

Iacò

et al. 2014

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussionmentioning

confidence: 99%

Chordal cutting in ischemic mitral regurgitation: A propensity-matched study

Calafiore

Refaie

Iacò

et al. 2014

The Journal of Thoracic and Cardiovascular Surgery

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“…10,11,226,237,275,277,279–283 Chordal modi‐fication can relieve tethering by cutting the secondary chordae that most restrict leaflet motion or by implanting chords to reduce the papillary muscle‐to‐annulus tethering distance. 276,278,284–289 Saddle‐shaped annuloplasty can also reduce leaflet stress 48,112 and improve coaptation. 47,50 Papillary muscle resynchronization and leaflet augmentation are additional options for the reduction of mitral regurgitation.…”

Section: Ischaemic Mitral Regurgitationmentioning

confidence: 99%

Mitral valve disease—morphology and mechanisms

Levine¹,

Hagège²,

Judge³

et al. 2015

Nat Rev Cardiol

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309

254

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Mitral valve disease is a frequent cause of heart failure and death. Emerging evidence indicates that the mitral valve is not a passive structure, but—even in adult life—remains dynamic and accessible for treatment. This concept motivates efforts to reduce the clinical progression of mitral valve disease through early detection and modification of underlying mechanisms. Discoveries of genetic mutations causing mitral valve elongation and prolapse have revealed that growth factor signalling and cell migration pathways are regulated by structural molecules in ways that can be modified to limit progression from developmental defects to valve degeneration with clinical complications. Mitral valve enlargement can determine left ventricular outflow tract obstruction in hypertrophic cardiomyopathy, and might be stimulated by potentially modifiable biological valvular–ventricular interactions. Mitral valve plasticity also allows adaptive growth in response to ventricular remodelling. However, adverse cellular and mechanobiological processes create relative leaflet deficiency in the ischaemic setting, leading to mitral regurgitation with increased heart failure and mortality. Our approach, which bridges clinicians and basic scientists, enables the correlation of observed disease with cellular and molecular mechanisms, leading to the discovery of new opportunities for improving the natural history of mitral valve disease.

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“…Primary chords are responsible for leaflet apposition, but when pathologic, result in regurgitation. Secondary or "strut" chords contribute toward maintenance of normal ventricular geometry, and abnormalities do not have adverse effects on leaflet coaptation (9). There is 1 anterolateral PM compared with the multiheaded posteroProbe Positioning for 3-Dimensional Echocardiography En Face Image Acquisition (Fig.…”

Section: Mitral Valvementioning

confidence: 99%

Valvular Heart Disease

Lang

Tsang

Weinert

et al. 2011

Journal of the American College of Cardiology

109

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Significant advances in 3-dimensional echocardiography (3DE) technology have ushered its use into clinical practice. The recent advent of real-time 3DE using matrix array transthoracic and transesophageal transducers has resulted in improved image spatial resolution, and therefore, enhanced visualization of the pathomorphological features of the cardiac valves compared with previously used sparse array transducers. It has enabled an unparalleled real-time visualization of valves and subvalvular anatomic features from a single volume acquisition without the need for offline reconstruction. On-cart or offline post-processing using commercially available and custom 3-dimensional analysis software allows the quantification of multiple parameters, such as orifice area, prolapse height and volume in mitral valve disease, area of the left ventricular outflow tract, and tricuspid annular geometry. In this review, we discuss the incremental role of 3DE in evaluating valvular anatomic features, volumetric quantification, pre-surgical planning, intraprocedural guidance, and post-procedural assessment of valvular heart disease.

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Relief of Mitral Leaflet Tethering Following Chronic Myocardial Infarction by Chordal Cutting Diminishes Left Ventricular Remodeling

Cited by 36 publications

References 49 publications

Chordal cutting in ischemic mitral regurgitation: A propensity-matched study

Chordal cutting in ischemic mitral regurgitation: A propensity-matched study

Mitral valve disease—morphology and mechanisms

Valvular Heart Disease

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