Intermediate-term results of a nonresectional dynamic repair technique in 662 patients with mitral valve prolapse and mitral regurgitation

Lawrie, Gerald M.; Earle, Elizabeth A.; Earle, Nan

doi:10.1016/j.jtcvs.2010.02.044

Cited by 61 publications

(64 citation statements)

References 21 publications

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“…Strain analysis showed normal strain distribution in all cases [11]. No patient has undergone reoperation for SAM [7].…”

Section: Invited Commentarymentioning

confidence: 83%

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Invited Commentary

Lawrie

2014

The Annals of Thoracic Surgery

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“…Strain analysis showed normal strain distribution in all cases [11]. No patient has undergone reoperation for SAM [7].…”

Section: Invited Commentarymentioning

confidence: 83%

“…We have reported 100% reparability [7], superior durability of the annulus attachment [7,8], and restoration of near normal annular dynamics [9,10]. Left ventricular outflow tract dimensions and aortic-mitral angle by cMRI are unchanged postoperatively.…”

Section: Invited Commentarymentioning

confidence: 99%

Invited Commentary

Lawrie

2014

The Annals of Thoracic Surgery

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“…Our cohort was consecutive patients with severe chronic MR who underwent CMR imaging before MVREP between November 2008 and March 2013. All enrolled patients underwent MVREP with a nonresectional dynamic technique by one experienced cardiac surgeon [10]. Institutional review board approval was obtained for this study.…”

Section: Methodsmentioning

confidence: 99%

Prognostic Value of Delayed Enhancement Cardiac Magnetic Resonance Imaging in Mitral Valve Repair

Chaikriangkrai

Lopez‐Mattei

Lawrie

et al. 2014

The Annals of Thoracic Surgery

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“…This technique has been shown to have a freedom from reoperation at 10 years of 90% and freedom from recurrent mitral regurgitation at 10 years of 94%. 39 This success is reflected by early post-operative 3D TEE studies that demonstrate preservation of dynamic changes in mitral annular structure during the cardiac cycle in patients who receive the American correction when compared with patients who received the Carpentier method. 2,40,41 In particular, the use of a flexible annuloplasty ring has been shown to preserve physiological mitral annular folding dynamics, which may be important in long-term valve function and prevention of left ventricular outflow tract obstruction.…”

Section: D Echocardiography Changes the Operation Performedmentioning

confidence: 99%

Three-dimensional Echocardiography Is Essential for Intraoperative Assessment of Mitral Regurgitation

Tsang

Lang²

2013

Circulation

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Since its introduction, 3-dimensional (3D) transesophageal echocardiography (TEE) has become widely adopted in operating rooms and cardiac catheterization laboratories worldwide. This is because the matrix-array 3D TEE probe allows acquisition of high-quality 3D images in real time with relatively little training. The rapid adoption of this technology has proven that this innovative imaging modality provides additional clinical information beyond that obtained from 2-dimensional (2D) TEE images. These developments have enabled medical centers to create integrated valve programs in which surgeons, interventionalists, and echocardiographers discuss cases and surgical approaches. Response by McCarthy on p 652In particular, 3D TEE has been proven to be superior to 2D TEE in the assessment of both mitral valve anatomy and mitral regurgitation, promoting its use in the operating room (Table 1). [1][2][3] One reason for this superiority is that 3D TEE allows the mitral valve to be displayed en face in an orientation identical to the surgeon's view of the mitral valve intraoperatively. This surgeon's view greatly facilitates communication with cardiac surgeons because they can easily interpret these images.Here, we argue that the widespread acceptance and use of 3D TEE are attributable to the pivotal role this modality plays in the intraoperative assessment of mitral regurgitation. We believe that 3D TEE of the mitral valve is invaluable not only because of the realistic images it provides but also because it improves: 1) lesion localization, 2) identification of the mechanisms causing mitral regurgitation, 3) quantification of the severity of mitral regurgitation, 4) selection of surgical intervention, 5) the choice of the surgeon whose expertise is best suited to perform the operation, 6) guidance of percutaneous mitral valve procedures, and 7) postoperative assessment. 3D Echocardiography of the Mitral ValveAccurate preoperative assessment of the mitral valve is critical in the surgical management of patients with severe mitral regurgitation. This information determines whether the patient should undergo valve repair or replacement, which has implications in terms of timing of surgery and long-term morbidity and mortality. 4 Traditionally, 2D TEE has been used to evaluate mitral valve anatomy. However, 2D TEE requires manual manipulation of the transducer in the esophagus and various degrees of flexion or anteflexion of the probe to acquire the standard mid-esophageal views and to examine all leaflet scallops. Since 2D TEE only provides single plane images, the entire mitral annulus and leaflets are not displayed in a single en face view, making it difficult to identify specific scallops with precision. As well, because the mitral annulus is saddle shaped, distortions of mitral valve anatomy, mitral annular dilatation, or aortic root enlargement may change the orientation of the ultrasound plane in relation to mitral valve apparatus, resulting in scallop misidentification.

show abstract

Intermediate-term results of a nonresectional dynamic repair technique in 662 patients with mitral valve prolapse and mitral regurgitation

Abstract: This study confirms that mitral regurgitation from mitral leaflet prolapse can be repaired in all cases by a nonresectional technique provided that accurate dynamic evaluation of chordal length and annular sizing is achieved. The intermediate-term results are durable.

Cited by 61 publications

References 21 publications

Invited Commentary

Invited Commentary

Prognostic Value of Delayed Enhancement Cardiac Magnetic Resonance Imaging in Mitral Valve Repair

Three-dimensional Echocardiography Is Essential for Intraoperative Assessment of Mitral Regurgitation

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