The anatomy and blood supply of the papillary muscles of the left ventricle

Estes, E. Harvey; Dalton, F; Entman, Mark L.; Dixon, H. B. F.; Hackel, Donald B.

doi:10.1016/0002-8703(66)90475-3

Cited by 187 publications

(66 citation statements)

References 6 publications

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“…25 Despite normal flow to a part of the anterior papillary muscle, the majority of the muscle (six of the nine segments analyzed) becomes severely ischemic during LAD or diagonal artery occlusion. This degree of ischemia causes reduction in thickening equal in magnitude to that of the more homogeneously ischemic posterior papillary muscle.…”

Section: Flow Versus Thickening Of Papillary Musclesmentioning

confidence: 96%

Mechanism of ischemic mitral regurgitation. An experimental evaluation.

et al. 1991

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Background. Papillary muscle dysfunction (PMD) has been implicated in the pathogenesis of ischemic mitral regurgitation (MR). We hypothesized that ischemic MR is not caused by PMD and/or dysfunction of the myocardial regions from where the papillary muscles arise but is related to reduction in global left ventricular (LV) function. To test this hypothesis, three groups of dogs were studied.Methods and Results. In group 1 dogs (n=8), varying degrees of regional and global LV

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Section: Flow Versus Thickening Of Papillary Musclesmentioning

confidence: 96%

Mechanism of ischemic mitral regurgitation. An experimental evaluation.

et al. 1991

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“…Posteromedial (posterior) papillary muscle arises from the junction of posterior wall and interventricular septum. 1,6,7 Morphologically, the papillary muscles can be classified as conical, mammillated, flat topped, grooved, stepped, wavy, arched, sloped, saucerised, two tiered, interlinked, parallel, V, Y or H-shaped. 8 Papillary muscles can be classified into three broad categories depending upon the nature of attachment to ventricular wall and relative length of body of papillary muscle that protrude freely into the ventricular cavity.…”

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confidence: 99%

“…Foci of necrosis or fibrosis are commonly seen in them particularly in the posteromedial papillary muscle, which has a poorer blood supply than anterolateral papillary muscle. 12 The axis of papillary muscles is generally oriented in a direction parallel to the axis of the left ventricular cavity 7 and is almost perpendicular to the atrioventricular ring. This orientation provides mechanical advantage in that tension developed by the papillary muscles is applied almost perpendicular to the mitral valve leaflets.…”

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confidence: 99%

A Morphometric Study of the Papillary Muscles of the Left Ventricles of Human Cadaveric Hearts in North-West Indian Population

Aulakh¹,

Saxena²,

Aneja³

et al. 2016

jemds

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BACKGROUND Atrioventricular (AV) valvular apparatus comprises of AV orifice and its annulus, valvular leaflets, chordae tendineae and papillary muscles. The study was done with a purpose to find out the gross morphology of papillary muscle of left ventricle and to compare any gender differences. This is helpful in understanding left atrioventricular valve dysfunction like mitral regurgitations and also helpful in valve repair surgeries.Aims of this Study 1. To note the shape, origin, number of heads and other gross features of papillary muscles of left ventricle. 2. To find out sexual difference in the gross morphology of papillary muscles of left ventricle. MATERIALS AND METHODSThe study was carried out in 30 apparently normal cadaveric hearts after fixing in 10% formalin. The left ventricle was opened after giving an incision and gross morphology of papillary muscles of left ventricles was studied by using Vernier calliper. Statistical analysis SPSS software and unpaired 't' test was used. P value less than 0.05 was taken as significant. RESULTS AND CONCLUSIONIt was found that both the anterolateral and posteromedial papillary muscles of left ventricle were always present. Number of heads of papillary muscles ranged from 1 to 6 in left ventricle. Length of anterolateral papillary muscle (ALPM) was more than posteromedial papillary muscle (PMPM) of left ventricle. Mixed type of ALPM was found more frequently in females (92.3%) in the present study than in males (58.8%). This difference was statistically significant (p<0.05). Posteromedial papillary muscle of the left ventricle took origin mainly from middle 1/3 rd of left ventricle. Such cases occurred more frequently in females than in males. The difference was statistically significant (p<0.05). KEYWORDS

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“…[1,2] The vulnerability of the posteromedial papillary muscle is linked to its single primary blood supply that arises from the dominant coronary artery, whereas the anterolateral papillary muscle has a dual blood supply emanating from the left anterior descending (LAD) artery as well as the obtuse marginal branch of the circumflex (Cx) arteries. [1][2][3] However, infarction of both papillary muscles related to the occlusion of the right coronary artery (RCA) is extremely rare. Herein, we report a case with ischemic severe mitral regurgitation (MR) associated with the occlusion of the RCA which led to the infarction of both papillary muscles.…”

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confidence: 99%

Double papillary muscle infarction related to right coronary artery occlusion: a case report

Güllü¹

2013

Turk Gogus Kalp Dama

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Akut miyokard enfarktüsü sırasında arka papiller kas ön papiller kasa göre daha fazla etkilenir. Ancak her iki papiller kasın enfarktüsü ise oldukça nadirdir. Bu yazıda, sağ koroner arter tıkanıklığına bağlı olabilen iki taraflı papiller kas enfarktüsünün gözlendiği 62 yaşında bir erkek olgu sunuldu. Başarılı bir koroner arter baypas greftleme ve mitral kapak replasmanı sonrasında, hasta sorunsuz bir şekilde taburcu edildi.Anah tar söz cük ler: Akut miyokard enfarktüsü; papiller kas enfarktı; sağ koroner arter tıkanıklığı.Posterior papillary muscle is involved more frequently than the anterior papillary muscle during acute myocardial infarction. However, infarction of both papillary muscles is very rare. In this article, we report a 62-year-old male case with bilateral papillary muscle infarction which was likely related to occlusion of the right coronary artery. Following a successful coronary artery bypass grafting and mitral valve replacement, the patient was discharged without any complication.

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The anatomy and blood supply of the papillary muscles of the left ventricle

Cited by 187 publications

References 6 publications

Mechanism of ischemic mitral regurgitation. An experimental evaluation.

Mechanism of ischemic mitral regurgitation. An experimental evaluation.

A Morphometric Study of the Papillary Muscles of the Left Ventricles of Human Cadaveric Hearts in North-West Indian Population

Double papillary muscle infarction related to right coronary artery occlusion: a case report

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