ArticleThe Annals of thoracic surgery2014
Posterior papillary muscle anchoring affects remote myofiber stress and pump function: finite element analysis.
Article in The Annals of thoracic surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 7 citations in OpenAlex.
- Article
- Finite element analysis of annuloplasty and papillary muscle relocation on a patient-specific mitral regurgitation model.PloS one · 2018Article
- Undersized Mitral Annuloplasty Increases Strain in the Proximal Lateral Left Ventricular Wall.The Annals of thoracic surgery · 2017Article
- Diffusion Tractography of the Entire Left Ventricle by Using Free-breathing Accelerated Simultaneous Multisection Imaging.Radiology · 2017Article
- Finite Element Modeling of Mitral Valve Repair.Journal of biomechanical engineering · 2016Review
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe role of posterior papillary muscle anchoring (PPMA) in the management of chronic ischemic mitral regurgitation (CIMR) is controversial. We studied the effect of anchoring point direction and relocation displacement on left ventricular (LV) regional myofiber stress and pump function.
methodsPreviously described finite element models of sheep 16 weeks after posterolateral myocardial infarction (MI) were used. True-sized mitral annuloplasty (MA) ring insertion plus different PPM anchoring techniques were simulated. Anchoring points tested included both commissures and the central anterior mitral annulus; relocation displacement varied from 10% to 40% of baseline diastolic distance from the PPM to the anchor points on the annulus. For each reconstruction scenario, myofiber stress in the MI, border zone, and remote myocardium as well as pump function were calculated.
resultsPPMA caused reductions in myofiber stress at end-diastole and end-systole in all regions of the left ventricle that were proportional to the relocation displacement. Although stress reduction was greatest in the MI region, it also occurred in the remote region. The maximum 40% displacement caused a slight reduction in LV pump function. However, with the correction of regurgitation by MA plus PPMA, there was an overall increase in forward stroke volume. Finally, anchoring point direction had no effect on myofiber stress or pump function.
conclusionsPPMA reduces remote myofiber stress, which is proportional to the absolute distance of relocation and independent of anchoring point. Aggressive use of PPMA techniques to reduce remote myofiber stress may accelerate reverse LV remodeling without impairing LV function.
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