Elimination of Ischemic Mitral Regurgitation Does Not Alter Long-Term Left Ventricular Remodeling in the Ovine Model Kanji Matsuzaki, MD, PhD, Masato.

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Elimination of Ischemic Mitral Regurgitation Does Not Alter Long-Term Left Ventricular Remodeling in the Ovine Model Kanji Matsuzaki, MD, PhD, Masato Morita, MD, Hirotsugu Hamamoto, MD, Mio Noma, MD, J. Daniel Robb, MBBS, Matthew J. Gillespie, MD, Joseph H. Gorman, MD, Robert C. Gorman, MD The Annals of Thoracic Surgery Volume 90, Issue 3, Pages 788-794 (September 2010) DOI: 10.1016/j.athoracsur.2010.04.008 Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Flow chart showing the experimental protocol. (IMR = ischemic mitral regurgitation; MI = myocardial infarction.) The Annals of Thoracic Surgery 2010 90, 788-794DOI: (10.1016/j.athoracsur.2010.04.008) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Infarct characteristics. (A) Posterior view of an ovine heart as viewed through a right thoracotomy. All branches of the circumflex coronary artery that cross the lateral margin of the left ventricle (LV) and supply the posterobasal wall between the lateral cardiac vein and the middle cardiac vein are ligated (RV = right ventricle.) (B) View of the ovine left ventricle open through the intraventricular septum 24 weeks after the posterobasal myocardial infarction depicted in Panel A. The infarct involves most of the posterior left ventricular wall and the entire posterior papillary muscle. (C) Infarct size as determined by postmortem planimetry in control and annuloplasty groups. Error bars represent standard deviations. The Annals of Thoracic Surgery 2010 90, 788-794DOI: (10.1016/j.athoracsur.2010.04.008) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Echocardiographic data for annuloplasty group (dashed line) and control group (solid line): (A) Serial left ventricular (LV) end systolic volume normalized to preinfarction value. Annuloplasty was placed 8 weeks after myocardial infarction (MI) in the annuloplasty group. The control group received no treatment. (B) Serial left ventricular end diastolic volume normalized to preinfarction value. (C) Serial ejection fraction (EF). (D) Degree of mitral regurgitation (MR) on standard 0 to 4 scale. The only statistically significant difference between groups was the degree of mitral regurgitation at 16 and 24 weeks after myocardial infarction. Error bars represent standard deviations. The Annals of Thoracic Surgery 2010 90, 788-794DOI: (10.1016/j.athoracsur.2010.04.008) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions