Cineangiographic diagnosis of papillary muscle involvement in rheumatic mitral stenosis

Left ventricular cineangiography was performed in 25 patients with normal mitral valves and in 49 patients with rheumatic mitral valve disease to estimate the spatial relations between the mitral valve leaflets and papillary muscles. The findings in the pathologic group were compared with observations at operation or with the excised mitral valves. It is concluded that fusion of the papillary muscles with the mitral valve leaflet or severe shortening of the chordae is predicted with a reasonable accuracy preoperatively by means of left ventricular cineangiography. The surgical implications are discussed.