Anterior mitral leaflet mobility is limited by the basal stay chords

We hypothesize that 2 tendon-like anterior basal stay chords, which remain taut during the entire cardiac cycle, limit the motion of the anterior mitral leaflet. Sonomicrometric crystals were implanted in 6 sheep at the insertion of stay chords at anterior mitral leaflet (S1 and S2), papillary muscl...

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Published in:Circulation (New York, N.Y.) N.Y.), 2003-06, Vol.107 (23), p.2969-2974
Main Authors: GOETZ, Wolfgang A, LIM, Hou-Sen, PEKAR, Filip, SABER, Hashim A, WEBER, Patricia A, LANSAC, Emmanuel, BIRNBAUM, Dietrich E, DURAN, Carlos M. G
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Cardiac Surgical Procedures
Chordae Tendineae - physiology
Chordae Tendineae - surgery
Echocardiography
Electrodes, Implanted
Fundamental and applied biological sciences. Psychology
Heart
Heart - physiology
Hemodynamics
Implants, Experimental
Mitral Valve - physiology
Mitral Valve - surgery
Papillary Muscles - physiology
Sheep
Systole - physiology
Ultrasonography - instrumentation
Vertebrates: cardiovascular system
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Summary:We hypothesize that 2 tendon-like anterior basal stay chords, which remain taut during the entire cardiac cycle, limit the motion of the anterior mitral leaflet. Sonomicrometric crystals were implanted in 6 sheep at the insertion of stay chords at anterior mitral leaflet (S1 and S2), papillary muscle tips, fibrous trigones, mitral annulus, and the tip of the anterior leaflet (AL). Distances between crystals were recorded before and after section of stay chords. During the cardiac cycle, the angle alpha between mitral annulus and AL changed by +54.2+/-12.4 degrees; the angles between mitral annulus and S1 (beta1) changed by +25.7+/-14.6 degrees, and between mitral annulus and S2 (beta2) by +20.4+/-7.8 degrees. During diastole, AL twice crossed the virtual plane formed by the stay chords: during E-wave by a maximum of 6.5 mm (mean, 2.5+/-2.2 mm) and during A-wave by a maximum of 3.2 mm (mean, 1.7+/-0.9 mm). After section of both stay chords, total anterior mitral leaflet motion increased as follows: AL, +6.9+/-3.4 degrees; S1, +13.1+/-4.4 degrees; and S2, +30.9+/-11.7 degrees (P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.0000070932.22543.C1