Left ventricular infarct plication restores mitral function in chronic ischemic mitral regurgitation

Ramadan, Ramzi; Al‐Attar, Nawwar; Mohammadi, Siamak; Ghostine, Saïd; Azmoun, Alexandre; Therasse, Alexis; Kortas, Chokri; Caussin, Christophe; Nottin, R

doi:10.1016/j.jtcvs.2004.05.017

Cited by 34 publications

(13 citation statements)

References 6 publications

(2 reference statements)

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“…This procedure was effective in reducing moderate CIMR to mild or trace CIMR, without changing LV ejection fraction and with the additional advantage of preventing opening of the left side of the heart [157]. Recently, infarct plication for CIMR was described in humans [158]. CABG without MVA was combined with infarct plication of the posterolateral infarcted myocardial region in three patients with grade 3+ CIMR.…”

Section: Pm Repositioning By Infarct Plicationmentioning

confidence: 99%

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Chronic ischaemic mitral regurgitation. Current treatment results and new mechanism-based surgical approaches☆

Bouma

Horst²,

Hamer

et al. 2010

European Journal of Cardio-Thoracic Surgery

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Chronic ischaemic mitral regurgitation (CIMR) remains one of the most complex and unresolved aspects in the management of ischaemic heart disease. This review provides an overview of the present knowledge about the different aspects of CIMR with an emphasis on mechanisms, current surgical treatment results and new mechanism-based surgical approaches. CIMR occurs in approximately 20-25% of patients followed up after myocardial infarction (MI) and in 50% of those with post-infarct congestive heart failure (CHF). The presence of CIMR adversely affects prognosis, increasing mortality and the risk of CHF in a graded fashion according to CIMR severity. The primary mechanism of CIMR is ischaemia-induced left ventricular (LV) remodelling with papillary muscle displacement and apical tenting of the mitral valve leaflets. CIMR is often clinically silent, and colour-Doppler echocardiography remains the most reliable diagnostic tool. The most commonly performed surgical procedure for CIMR (restrictive annuloplasty combined with coronary artery bypass grafting (CABG)) can provide good results in selected patients with minimal LV dilatation and minimal tenting. However, in general the persistence and recurrence rate (at least MR grade 3+) for restrictive annuloplasty remains high (up to 30% at 6 months postoperatively), and after a 10-year follow-up there does not appear to be a survival benefit of a combined procedure compared to CABG alone (10-year survival rate for both is approximately 50%). Patients at risk of annuloplasty failure based on preoperative echocardiographic and clinical parameters may benefit from mitral valve replacement with preservation of the subvalvular apparatus or from new alternative procedures targeting the subvalvular apparatus including the LV. These new procedures include second-order chordal cutting, papillary muscle repositioning by a variety of techniques and ventricular approaches using external ventricular restraint devices or the Coapsys device. In addition, percutaneous transvenous repair techniques are being developed. Although promising, at this point these new procedures still lack investigation in large patient cohorts with long-term follow-up. They will, however, be the subject of much anticipated and necessary ongoing and future research.

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Section: Pm Repositioning By Infarct Plicationmentioning

confidence: 99%

“…CABG without MVA was combined with infarct plication of the posterolateral infarcted myocardial region in three patients with grade 3+ CIMR. After a mean follow-up of 7 months, all three patients had grade 0 CIMR (Table 2) [158].…”

Section: Pm Repositioning By Infarct Plicationmentioning

confidence: 99%

Chronic ischaemic mitral regurgitation. Current treatment results and new mechanism-based surgical approaches☆

Bouma

Horst²,

Hamer

et al. 2010

European Journal of Cardio-Thoracic Surgery

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“…Ramadan et al [10] described a different method to plicate the inferior wall; the bites were passed parallel to the long-axis of the LV, so as to decrease long-axis length. We think that this orientation could increase the sphericalization of the ventricle instead of leaving a conical shape, as with our technique.…”

Section: Discussionmentioning

confidence: 99%

Left ventricular free-wall plication for ischemic cardiomyopathy: safe and effective?

Salati¹,

DiMauro²

2010

Journal of Cardiovascular Medicine

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In 10 patients, a free-wall plication of inferior or lateral scar was performed. The procedure was done on cardiopulmonary bypass and aortic cross-clamping by means of four or five wide U-stitches. Six patients underwent concomitant mitral annuloplasty and one mitral valve replacement. One patient died postoperatively. There was a sudden and significative end-systolic volume reduction with a rise in ejection fraction. These hemodynamic benefits were partially lost during the follow-up but the mitral regurgitation grade remained unchanged.

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“…Ramadan и соавт. [41] представили результаты при-менения данной методики в сочетании с АКШ у 3 пациен-тов с 3-й степенью ишемической МР. Через 7 мес после операции у всех пациентов отсутствовала МР.…”

Section: репозиция папиллярных мышц путем пликации области инфаркта мunclassified

Surgical approaches to treatment of ischemic mitral regurgitation (literature review)

Бузиашвили¹,

Бузиашвили²,

Buziashvili³

et al. 2015

Kardiol. serdechno-sosud. khir.

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Left ventricular infarct plication restores mitral function in chronic ischemic mitral regurgitation

Cited by 34 publications

References 6 publications

Chronic ischaemic mitral regurgitation. Current treatment results and new mechanism-based surgical approaches☆

Chronic ischaemic mitral regurgitation. Current treatment results and new mechanism-based surgical approaches☆

Left ventricular free-wall plication for ischemic cardiomyopathy: safe and effective?

Surgical approaches to treatment of ischemic mitral regurgitation (literature review)

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