Annular-to-Leaflet Mismatch and the Need for Reductive Annuloplasty in Patients Undergoing Mitral Repair for Chronic Mitral Regurgitation Due to Mitral Valve Prolapse

Maisano, Francesco; Canna, Giovanni La; Grimaldi, Antonio; Viganò, Giorgio; Blasio, Andrea Di; Mignatti, Andrea; Colombo, Antonio; Maseri, Attilio; Alfieri, Ottavio

doi:10.1016/j.amjcard.2006.12.072

Cited by 30 publications

(16 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The impact of annular‐to‐leaflet mismatch on MitraClip® success remains unresolved. Immediate postprocedural findings by Maisano et al suggest that patients who do not have an annular‐to‐leaflet mismatch (defined as an SL/ALH <1.4) may benefit from a minimally invasive mitral leaflet apposition (e.g., via MitraClip®) only, whereas patients with an annular‐to‐leaflet mismatch (SL/ALH >1.4) may require an annuloplasty in addition to leaflet apposition. However, our findings suggest that patients with pure FMR or MMR, both of which are characterized by an annular‐to‐leaflet mismatch, benefit from isolated leaflet apposition (without concomitant annuloplasty).…”

Section: Discussionmentioning

confidence: 99%

“…According to an ideal anatomic combination to obtain sufficient coaptation surface between the leaflets, we calculated the ratio between SL dimension and anterior and posterior leaflet height (ALH, anterior leaflet height; PLH, posterior leaflet height). Maisano et al 12 declared an SL/ALH ratio and SL/ALH þ PLH ratio of >1.4 and >0.7, respectively, as an annular-to-leaflet mismatch (requiring an annuloplasty ring in addition to leaflet repair). Based on these criteria, patients were The mid-esophageal 50-70°plane is used to measure the IC dimension; the long axis view at 140-160°view is used to measure the SL (also known as anteroposterior) dimension of the annulus in systole.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Change in Mitral Annular Size and Geometry after MitraClip® Implantation in Patients with Functional and Degenerative Mitral Regurgitation

Remy

Bertog

Wunderlich

et al. 2014

J Interven Cardiology

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Change in Mitral Annular Size and Geometry after MitraClip® Implantation in Patients with Functional and Degenerative Mitral Regurgitation

Remy

Bertog

Wunderlich

et al. 2014

J Interven Cardiology

View full text Add to dashboard Cite

show abstract

“…The Leaflet-to-Annulus Index (LAI) <1.4, defined as the ratio between the sum of anterior leaflet length and posterior leaflet length over antero-posterior length, can be used as reliable predictor to identify patients without annular dilatation (32,33). The LAI identifies the quantity of overlapping leaflet tissue that will represent the potential coaptation surface after the correction (Figure 7).…”

Section: Role Of Concomitant Annuloplasty To Artificial Chordaementioning

confidence: 99%

Transcatheter mitral valve chord repair

Savić

Pozzoli

Gülmez

et al. 2018

Ann. Cardiothorac. Surg.

Self Cite

View full text Add to dashboard Cite

The field of mitral valve disease diagnosis and management is rapidly evolving. New understanding of pathophysiology and improvements in the adoption of sophisticated multimodality imaging modalities have led to early diagnosis and to more complex treatment. The most common cause of mitral regurgitation (MR) in the western world is in the primary alteration of the valve, which leads to degenerative leaflet prolapse due to chordal elongation or rupture and annular dilatation. Untreated, significant MR has a negative impact prognosis, leading to reduction of survival. In the setting of degenerative MR, surgical repair currently represents the standard of care. Treatment of asymptomatic patients with severe MR in the Valve Center of Excellence, in which successful repair reaches more than 95% and surgical mortality less than 1%, symbolizes the direction for the next years. Transcatheter mitral valve repair with different devices, more recently the chordal replacement ones, is providing good outcomes and became a therapeutic option in highrisk patients with degenerative MR. In the future, more advances are expected from further development of interventional techniques, careful evaluation and better patient selection. This review will focus on long-term surgical outcomes of mitral valve repair with artificial chordae and on the emerging transcatheter chordal repair devices as therapeutic options for degenerative MR patients.

show abstract

“…Since patients are being referred for surgery earlier, the need for reductive annuloplasty in every patient becomes questionable [9].…”

Section: Introductionmentioning

confidence: 99%

Early echocardiographic results of transapical off-pump mitral valve repair with the NeoChord DS1000 device in patients with severe mitral regurgitation due to posterior leaflet prolapse: first experiences in Poland

Kurnicka

Wróbel²,

Zdończyk

et al. 2019

pwki

View full text Add to dashboard Cite

Introduction Minimally invasive techniques of mitral valve (MV) repair have been increasingly used in recent years. Transapical implantation of artificial chordae on a beating heart under 2D/3D transesophageal echocardiographic guidance with the NeoChord DS1000 device is a new surgical treatment of degenerative mitral regurgitation (MR). Aim To evaluate early results of MV repair with the NeoChord DS1000 device in the first group of consecutive patients operated on in Poland. Material and methods Twenty-one patients with severe MR due to posterior leaflet prolapse (81% male; mean age: 60.7 ±12.7 years) underwent MV repair with the NeoChord DS1000 system. There were 12 (57.1%) patients with type A (an isolated central prolapse/flail), 8 (38.1%) patients with type B (multisegment disease/flail) and 1 (4.8%) patient with type C (posterior/paracommisural area) MV prolapse. A flail leaflet was present in 12 (57.1%) patients. The median number of neochords was 3 (2–6). We assessed by echocardiography left-sided heart morphology and evaluated MR degree before and 6 months after chords implantation. Results Early procedural success was achieved in 100% of patients. At the 6-month follow-up nonsignificant MR (trace and mild) was detected in 17 (81.0%) patients, while moderate MR was detected in 4 (19.0%) patients; mean values of left-sided heart dimensions and volumes, mitral E and E’ velocity of lateral MV annulus significantly decreased. Conclusions A novel procedure with the NeoChord DS1000 device is feasible in properly selected patients, and results in a significant reduction of MR degree and left ventricle and left atrium reverse remodeling at the 6-month follow-up.

show abstract

Annular-to-Leaflet Mismatch and the Need for Reductive Annuloplasty in Patients Undergoing Mitral Repair for Chronic Mitral Regurgitation Due to Mitral Valve Prolapse

Cited by 30 publications

References 18 publications

Change in Mitral Annular Size and Geometry after MitraClip® Implantation in Patients with Functional and Degenerative Mitral Regurgitation

Change in Mitral Annular Size and Geometry after MitraClip® Implantation in Patients with Functional and Degenerative Mitral Regurgitation

Transcatheter mitral valve chord repair

Early echocardiographic results of transapical off-pump mitral valve repair with the NeoChord DS1000 device in patients with severe mitral regurgitation due to posterior leaflet prolapse: first experiences in Poland

Contact Info

Product

Resources

About