Suspension of the papillary muscles during valve replacement for mitral stenosis

Of 94 patients who underwent intravalvular mitral valve replacement with CarboMedics bileaflet mechanical prosthesis, 10 presented with heavily calcified stenotic valves. After total excision of the mitral valve in these patients, both papillary muscles were reconnected to the annulus with Goretex sutures. Repeat cardiac catheterization was completed in six of these 10 patients two to 24 months after surgery. Global and segmental left ventricular function was estimated using the MEDIS program (Thorax Centrum, Rotterdam) for analysis of left ventricular function. In five of the six patients re-examined, the ejection fraction was improved, the global ejection fraction increasing from 54% +/- 6% to 63% +/- 10%. We conclude, even though the number of followed patients is extremely small, that mitral valve replacement with suspension of the papillary muscles is surgically feasible and has beneficial effects on the contractility of the left ventricle in patients with mitral stenosis.