• Journal of Chest Surgery
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• v.25 no.9
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• pp.936-942
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• 1992

There are three types of papillary muscle of the left ventricle[finger, tethered and mixed type] according to the morphology of the attachment to the ventricular wall. Especially finger type of the papillary muscle is more vulnerable to the injury than tethered or mixed type, because their blood supply is dependent upon the central artery whose diameter is less than 1mm and the papillary muscle itself is the end organ of the heart anatomically. There are several causes of papillary muscle rupture but few cases have been reported. Recently we have experienced 3 cases of papillary muscle rupture of the left ventricle with successful mitral valve replacement and the causes are postmyocardial infarction, percutaneous mitral valvulotomy and non-penetrating chest trauma. The common finding is the morphology of papillary muscle, that is the finger type and their rupture type is the complete type.

• YAKHAK HOEJI
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• v.29 no.4
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• pp.199-205
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• 1985

It was previously reported that the deterioration rate of contractile force of the isolated heart from ginseng extract treated rat was slower than that from control. Present study was carried out to investigate the mechanism of the action of ginseng on the contractile force of the papillary muscle in terms of calcium metabolism. Rats weighing 200-300g were administered orally with ginseng ethanol extract (100mg/kg/day) for more than 10 days. The isolated papillary muscles from rat hearts were suspended in bath containing Krebs-Henseleit solution. When equilibration of contractile force of papillary muscle was reached, the rates of deterioration of contractile forces of papillary muscle from ginseng component treated rats were determined by washing with Ca-free Krebs-Henseleit solution and compared with that of normal hearts. At the beginning of washing, the rate of deterioration of contractile force of the papillary muscle was slower significantly in ginseng treated rats than in control rats, suggesting that calcium may be somehow involved in sustaining the contractility in ginseng treated hearts. Anoxia of papillary muscle with nitrogen gas to muscles inhibited the contractility, but differences between control and ginseng treated groups in the rate of deterioration were not observed. Influence of diltiazem, calcium blocker, on the contractility of papillary muscle from ginseng treated and control hearts was studied. Contractility of papillary muscle from control and ginseng treated hearts was inhibited by diltiazem in dose dependent manner but the inhibition of the ginseng treated muscles was much weak. The effect was significantly different. From the results, it seemed that slowing in deterioration rate of papillary muscle from ginseng treated hearts might be related to calcium which was mobilized from plasma membrane of internal organelle by ginseng.

• Journal of Chest Surgery
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• v.28 no.1
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• pp.69-72
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• 1995

A 69-year-old patient with rupture of anterolateral papillary muscle following non-Q-wave myocardial infarction is described. Transesophageal echocardiography was useful in making the diagnosis. Mitral valve replacement was performed 22 days after the onset of acute myocardial infarction. The patient was discharged in his good condition and coronary angiography is scheduled.

• The Journal of the Korean dental association
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• v.16 no.7 s.110
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• pp.531-536
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• 1978

Adult cats were light anesthetized with ethyl ether and heart was removed fastly. cardiac papillary muscle was dissected from heart in organ bath con taining Tyrode solution saturated with 95% O₂+5% CO₂, and prepared papillary muscles were placed in Tyrode solution that was continuously circulated and gassed with 95% O₂+5% CO₂at 32℃. The isolated papillary muscle was stimulated continuously with platinum pin electrode at frequency of 15/min and 90/min by means of electric stimulator and transmembrane action potentials were recorded with microelectrdes on the oscilloscope. The drug used was d-propranolol and its concentration was 0.5, 1.5 and 5.0 mg/L. The results obtained were as follows: 1. D-propranolol increased the threshold voltage of papillary muscle and raised by average of 213.6% of control. 2. D-propranolol had no effect on duration of action potential. 3. Conduction time of isolated papillary muscle was increased by d-propranolol and its effect was prominent at frequency of 90/min. 4. the maximum upstroke velocity was decreased by d-propranolol and its effect was dose-depndent decrease.

• Journal of Chest Surgery
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• v.44 no.4
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• pp.285-287
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• 2011

A 53-year-old man presenting with dyspnea and chest pain was diagnosed with acute myocardial infarction secondary to occlusion of the left circumflex coronary artery. Urgent revascularization by percutaneous stenting was successfully performed. However, the post-echocardiography revealed a ruptured papillary muscle that was causing severe mitral regurgitation and aggravation of congestive heart failure. The patient subsequently underwent mitral valve repair with papillary muscle re-implantation. Postoperative echocardiography showed a competent mitral valve without residual stenosis or regurgitation. The patient was discharged from the hospital with an uneventful recovery and has been doing well on outpatient follow up.

• Journal of Chest Surgery
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• v.55 no.3
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• pp.239-242
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• 2022

Papillary muscle rupture with severe acute mitral regurgitation is a rare complication of acute myocardial infarction (AMI) that causes pulmonary congestion and cardiogenic shock. Moreover, it has a poor prognosis. Surgical intervention, including revascularization, is indicated; however, surgical mortality remains high. We report the case of an 85-year-old woman with cardiogenic shock from severe acute mitral regurgitation, in whom a hybrid intervention, combining percutaneous coronary intervention with mitral valve replacement via minithoracotomy, was performed after post-infarction papillary muscle rupture. She was discharged in a favorable clinical condition. We describe a novel hybrid intervention for treating a rare complication of AMI, which could minimize surgical invasion in elderly patients, prevent disuse syndrome after the intervention, and improve prognosis. However, mitral valve surgery via minithoracotomy for emergency cases requires technical proficiency, as well as collaboration with other healthcare professionals, and the choice to perform this procedure requires careful consideration.

• Journal of Veterinary Clinics
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• v.34 no.4
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• pp.279-282
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• 2017

A 9-month-old, female, mixed-breed dog was presented with dyspnea, exercise intolerance and a left apical heart murmur. Echocardiography revealed mitral systolic regurgitant flow by morphological abnormalities of the mitral apparatus including dilated annulus, excessively asymmetric mitral leaflets, short and stout chordae tendinae, and atrophic papillary muscles. The dog was diagnosed with congenital mitral dysplasia based on the echocardiographic features. Two months later, the dog died and the echocardiographic findings were confirmed by necropsy. This case report describes the echocardiographic features of mitral dysplasia with papillary muscle atrophy, and compares the gross necropsy findings in a dog.

• Journal of Chest Surgery
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• v.39 no.1 s.258
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• pp.64-67
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• 2006

Anterior papillary muscle rupture caused by occlusion of the first diagonal branch is reported to be very rare. A 66-year-old woman was transferred to our hospital for acute myocardial infarction and cardiogenic shock. Echocardiography and angiography revealed severe mitral regurgitation caused by rupture of the anterior papillary muscle and the complete occlusion of the first diagonal branch. In an emergent setting, she had been successfully treated by mitral valve replacement and coronary artery bypass grafting. She was discharged on postoperative twelfth day without any event.

• The Korean Journal of Physiology
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• v.19 no.2
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• pp.127-137
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• 1985

The present study was undertaken in order to investigate effect of ethanol extract of Rehmanniae radix(RREE) on electrophysiology of sinus node and papillary muscle. Rehmanniae radix is a herbal medicine which has been known to have diuretic, antipyretic, hemopoietic and cardiotonic effects. Action potentials were recorded by means of glass capillary microelectrode(technique) in rabbit sinoatrial nodal cells and papillary muscle cells which were superperfused with either tyrode solution or tyrode solutions containing different amount of RREE. The results obtained were as follows ; 1) In both central and peripheral nodal cells maximum diastolic potential (MDP) and amplitude of action potential (APA) were not affected by RREE. 2) Action potential duration as expressed $APD_{60}$(time to 60% repolarization) of central and peripheral pacemaker cells were significantly prolonged following perfusion with tyrode solution containing 0.1% RREE. 3) The rates of spontaneous firing from central pecemaker cell were decreased by RREE at concentration of 0.05% and 0. 1% while spontaneous rhythm of perinodal cell was decreased by 0.1% RREE. 4) The action potential duration of papillary muscle as expressed $APD_{60}$ were prolonged by 0.1% RREE.

• YAKHAK HOEJI
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• v.32 no.6
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• pp.402-414
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• 1988

In order to clarify the receptor types and mechanisms underlying the positive inotropic effect of dopamine on the mammalian ventricular myocardium, the action potential, its first derivatives and isometric contraction of the rabbit papillary muscle were recorded using a force transducer and glass capillary microelectrodes filled with 3M KCl. The results were as follows; (1) In normal Tyrode solution, the contractile force was increased and duration of action potential was shortened with increments of dopamine concentration ($10^{-6}-10^{-4}M$). (2) The dose-response curve was markedly shifted to the right by pretreatment with reserpine (5mg/kg i.p., 24hrs prior to the experiment). (3) In 19mM $K^+-Tyrode$ solution, the duration of action potential, maximum rate of rise (V_{max}) of action potential and overshoot were significantly increased with increments of dopamine concentration ($10^{-6}-10^{-4}M$). (4) The inotropic effect of dopamine on the rabbit papillary muscle pretreated with reserpine was antagonized by atenolol ($10^{-6}M$), but not by phentolamine ($3{\times}10^{-6}M$). (5) In rabbit papillary muscle partially depolarized by 19mM $K^+-Tyrode$ solution, slow electrical response (calcium mediated action potential) as well as contraction were restored by dopamine ($10^{-4}M$); this restoration was blocked by calcium antagonists ($3{\times}10^{-5}M$ $LaCl_3{\cdot}6H_2O$, $3{\times}10^{-6}M$ diltiazem) or ${\beta}-adrenoceptor$ antagonist ($3{\times}10^{-6}M$ atenolol), but not affected by ${\alpha}-adrenoceptor$ antagonist ($10^{-5}M$ phentolamine, $3{\times}10^{-6}M$ yohimbine) or vascular dopaminergic receptor antagonist ($10^{-5}M$ haloperidol). The above results may be interpreted as that the positive inotropic effect of dopamine through both direct and indirect action are caused by increase in slow inward current ($Ca^{2+}$ influx into themyocardial cell), and the direct action is mainly due to the stimulation of ${\beta}-adrenoceptors$ in the rabbit papillary muscle.