ArticleJTCVS open2021
Papillary Muscle Approximation Reduces Systolic Tethering Forces and Improves Mitral Valve Closure in the Repair of Functional Mitral Regurgitation.
Article in JTCVS open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 15 citations in OpenAlex.
- Evaluation of Left Ventricular Papillary Muscles Using Targeted Views by Echocardiography.Journal of clinical medicine · 2026Article
- Advanced Silicon Modeling of Native Mitral Valve Physiology: A New Standard for Device and Procedure Testing.Bioengineering (Basel, Switzerland) · 2025Article
- Interactive Effects Between Papillary Muscle Approximation and Ring Annuloplasty to Repair Functional Mitral Regurgitation in Enlarged Ventricles.Functional imaging and modeling of the heart : ... International Workshop, FIMH ..., proceedings. FIMH (Conference) · 2025Article
- GeminiOne transcatheter edge-to-edge repair: comparative hemodynamic and biomechanical evaluation.Frontiers in cardiovascular medicine · 2025Article
- Computational Modeling of the Subject-Specific Effects of Annuloplasty Ring Sizing on the Mitral Valve to Repair Functional Mitral Regurgitation.Annals of biomedical engineering · 2023Article
- Utilization of Engineering Advances for Detailed Biomechanical Characterization of the Mitral-Ventricular Relationship to Optimize Repair Strategies: A Comprehensive Review.Bioengineering (Basel, Switzerland) · 2023Review
- Research Opportunities in the Treatment of Mitral Valve Prolapse: JACC Expert Panel.Journal of the American College of Cardiology · 2022Review
- Patient-Specific Three-Dimensional Ultrasound Derived Computational Modeling of the Mitral Valve.Annals of biomedical engineering · 2022Article
- Ex Vivo Model of Ischemic Mitral Regurgitation and Analysis of Adjunctive Papillary Muscle Repair.Annals of biomedical engineering · 2021Article
- Article
- Commentary: Papillary muscle relocation for secondary mitral regurgitation: A never-ending story.JTCVS open · 2021Article
- Commentary: Is papillary muscle approximation the key to durable functional mitral regurgitation repair? Only time will tell.JTCVS open · 2021Article
- Commentary: What do we still have to learn from surgery?JTCVS open · 2021Article
- Isolated and combined effects of papillary muscle approximation and mitral annuloplasty in dilated left ventricles.JRSM cardiovascular diseaseArticle
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
Background: Undersizing mitral annuloplasty (UMA) to repair functional mitral regurgitation lacks durability, as it forces leaflet coaptation without relieving the sub-leaflet tethering forces. In this biomechanical study, we demonstrate that papillary muscle approximation (PMA) prior to UMA can drastically relieve tethering forces and improve valve function, without the need for significant annular downsizing. Methods: An Results: FMR geometry induced a 16.31±7.33% regurgitant fraction, compared to none at baseline. 30mm/TSR reduced regurgitation to 6.05±5.63% and a 26mm/DSR to 5.06±6.76%. Addition of papillary muscle approximation prior to either rings, reduced regurgitation to 3.87±6.79% with the true sized ring (TSR+PMA), and 3.71±6.25% with the downsized ring (DSR+PMA). Peak anterior and posterior marginal chordal forces were elevated to 0.09±0.1N and 0.12±0.1N respectively with FMR, which were not reduced by annuloplasty of either sizes. Addition of PMA, reduced the forces significantly to 0.23±0.02N and 0.51±0.04N. Conclusion: This biomechanical study, demonstrates that papillary muscle approximation relieves tethering forces and when added to annuloplasty, and mobilizes the leaflets to achieve a good valve closure. Such a result could be achieved without the need for extensive annular downsizing.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.