A physiological approach to surgery for acute rupture of the papillary muscle

P. A. Spence, C. M. Peniston, N. Mihic, T. E. David, A. K. Jabr, D. Archer, Tomas Salerno

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

There is controversy regarding the optimal management of patients in whom acute papillary muscle rupture develops. This study evaluates the effect of division of the anterolateral papillary muscle on left ventricular (LV) function and compares two methods of treatment - mitral valve replacement (MVR) and mitral valve repair. Thirteen pigs were placed on cardiopulmonary bypass, and interventions were performed in an isolated beating heart preparation. LV function was assessed with a compliant intraventricular balloon at baseline, after division of the anterolateral papillary muscle (Divided), after repair of the divided papillary muscle (Repair), and finally after MVR. Division of the anterolateral papillary muscle caused a significant deterioration in LV function. Function was maintained at this level after mitral valve repair but deteriorated with MVR. Developed pressure measured at baseline was 179 ± 13 mm Hg; Divided, 148 ± 11 mm Hg (p < 0.05 versus baseline); Repair, 149 ± 15 mm Hg; and MVR, 95 ± 8 mm Hg (p < 0.05 versus Divided) at a balloon volume of 20 ml. These results suggest that LV function is impaired by papillary muscle rupture. Repair of the ruptured papillary muscle is associated with better LV function than is MVR.

Original languageEnglish
Pages (from-to)27-30
Number of pages4
JournalAnnals of Thoracic Surgery
Volume42
Issue number1
StatePublished - Aug 27 1986
Externally publishedYes

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Papillary Muscles
Mitral Valve
Rupture
Left Ventricular Function
Cardiopulmonary Bypass
Swine
Pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Spence, P. A., Peniston, C. M., Mihic, N., David, T. E., Jabr, A. K., Archer, D., & Salerno, T. (1986). A physiological approach to surgery for acute rupture of the papillary muscle. Annals of Thoracic Surgery, 42(1), 27-30.

A physiological approach to surgery for acute rupture of the papillary muscle. / Spence, P. A.; Peniston, C. M.; Mihic, N.; David, T. E.; Jabr, A. K.; Archer, D.; Salerno, Tomas.

In: Annals of Thoracic Surgery, Vol. 42, No. 1, 27.08.1986, p. 27-30.

Research output: Contribution to journalArticle

Spence, PA, Peniston, CM, Mihic, N, David, TE, Jabr, AK, Archer, D & Salerno, T 1986, 'A physiological approach to surgery for acute rupture of the papillary muscle', Annals of Thoracic Surgery, vol. 42, no. 1, pp. 27-30.
Spence PA, Peniston CM, Mihic N, David TE, Jabr AK, Archer D et al. A physiological approach to surgery for acute rupture of the papillary muscle. Annals of Thoracic Surgery. 1986 Aug 27;42(1):27-30.
Spence, P. A. ; Peniston, C. M. ; Mihic, N. ; David, T. E. ; Jabr, A. K. ; Archer, D. ; Salerno, Tomas. / A physiological approach to surgery for acute rupture of the papillary muscle. In: Annals of Thoracic Surgery. 1986 ; Vol. 42, No. 1. pp. 27-30.
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