Mitral annuloplasty in patients with ischemic versus dilated cardiomyopathy

Szalay, Z.; Civelek, Ali; Hohe, S; Brunner‐LaRocca, Hans‐Peter; Klövekorn, W. P.; Knez, Igor; Vogt, Paul; Bauer, Erwin

doi:10.1016/s1010-7940(02)00864-3

Cited by 58 publications

(51 citation statements)

References 20 publications

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“…In our study, early mortality occurred in one patient in the MAP group (1.6%), and this is comparable to recent reports. 5,16,17) Regarding the indications for mitral valve procedures, Kang et al suggested that mitral valve repair was superior to CABG alone in patients with severe MR. However, in patients with moderate MR, the intraoperative mortality of mitral valve repair was higher than that of CABG alone, whereas MR improvement rates were similar in the two procedures.…”

Section: Discussionmentioning

confidence: 99%

Off Pump Coronary Artery Bypass versus Mitral Annuloplasty in Moderate Ischemic Mitral Regurgitation

Jeong

Lee

Kim

et al. 2012

ATCS

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Results: Freedom from cardiac-related death at eight years was similar between groups (78.4 ± 5.5%, the OPCAB group versus 81.5 ± 5.9%, the MAP group, p = 0.297). In patients with left ventricular ejection fraction (LVEF) >40%, the MAP group were similar to the OPCAB group in freedom from recurrent MR at eight years (85.7± 10.0% versus 84.9 ± 8.3%, p = 0.738), but a significant difference was found in patients with LVEF ≤40% (93.5± 4.5%, the MAP group versus 36.9 ± 18.4%, the OPCAB group, p = 0.013). On multivariate analysis, emergency operation and low LVEF were predictive of recurrent MR. Conclusion: Concomitant MAP was more effective against recurrent MR than was OPCAB alone, in patients with LVEF ≤40%. We suggest that MAP should be considered in moderate ischemic MR with low LVEF.

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Section: Discussionmentioning

confidence: 99%

Off Pump Coronary Artery Bypass versus Mitral Annuloplasty in Moderate Ischemic Mitral Regurgitation

Jeong

Lee

Kim

et al. 2012

ATCS

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“…However, we must note that recurrent MR leads to the recurrence of CHF, as was the case with the patient with persistent MR. Szalay et al reported that preoperative NYHA functional class IV was the only risk factor of recurrent MR after MAP in idiopathic DCM. 7 In the current study, the patient with recurrent MR was in NYHA functional class IV and had the most severe CHF before surgery among all the patients. The severity of preoperative functional status might be a sign of recurrent MR.…”

Section: Discussionmentioning

confidence: 64%

Isolated Undersized Mitral Annuloplasty for Functional Mitral Regurgitation in Non-Ischemic Dilated Cardiomyopathy Reconsideration of the Relationship Between Preoperative Coaptation Depth and Persistent Mitral Regurgitation

Miura

Eishi

Yamachika

et al. 2008

Circ J

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Background A preoperative coaptation depth (CD) ≥11 mm is apparently a predictive factor for persistent mitral regurgitation (MR) after undersized mitral annuloplasty for functional MR. The results of studies of isolated undersized mitral annuloplasty in non-ischemic dilated cardiomyopathy (DCM) are reported, including the relationship between the preoperative CD and recurrent MR. Methods and ResultsSix patients (mean age, 61 years) with severe functional MR in non-ischemic DCM underwent isolated undersized mitral annuloplasty. There were no hospital deaths. At intermediate follow-up of 2.2±1.9 years, New York Heart Association functional class improved significantly from 3.3±0.5 before surgery to 2.2±0.4 after surgery (p=0.0016). At a mean echocardiographic follow-up of 1.9±1.7 years, MR grade improved significantly from 4.0±0.0 before surgery to 1.0±0.6 after surgery (p<0.001). In 4 of 5 patients with a preoperative CD ≥11 mm, functional MR improved to mild or less than mild after surgery. Conclusions Isolated undersized mitral annuloplasty improved clinical symptoms and functional MR in nonischemic DCM. These results suggest that preoperative CD ≥11 mm does not always predict recurrent MR after isolated undersized mitral annuloplasty for functional MR in cases of non-ischemic DCM. (Circ J 2008; 72: 1744 -1750

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“…In this study, sheep with IMR had systolic and diastolic LV diameters (47Ϯ7 and 59Ϯ5 mm) similar to those observed in human IMR (50Ϯ1 and 64Ϯ1 mm). 25 That human clinical study with RT3D echo demonstrated increased mitral annular diameter and asymmetrical MV deformation (more severe tenting at the medial side than the lateral side) in IMR; in contrast, leaflet tenting was symmetrical in dilated cardiomyopathy. The present study in sheep with chronic IMR revealed similarities to human chronic IMR, including similar mitral annular dilatation and asymmetric MV deformation (more severe tenting at the medial than the lateral side).…”

Section: Discussionmentioning

confidence: 93%

Percutaneous Mitral Valve Repair for Chronic Ischemic Mitral Regurgitation

et al. 2005

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Background-Although surgical annuloplasty is the standard repair for ischemic mitral regurgitation (IMR), its application is limited by high morbidity and mortality. Using 2D and real-time 3D echocardiography in an ovine model of chronic IMR, we evaluated the geometric impact and short-term efficacy of a percutaneous transvenous catheter-based approach for mitral valve (MV) repair using a novel annuloplasty device placed in the coronary sinus. Methods and Results-Six sheep developed IMR 8 weeks after induced posterior myocardial infarction. An annuloplasty device optimized to reduce anterior-posterior (A-P) mitral annular dimension and MR was placed percutaneously in the coronary sinus. Mitral annular A-P and commissure-commissure dimensions and MV tenting area (MVTa) in 3 parallel A-P planes (medial, central, and lateral) were assessed by real-time 3D echocardiography with 3D software. The annuloplasty device reduced MR jet area from 5.4Ϯ2.6 to 1.3Ϯ0.9 cm 2 (PϽ0.01), mitral annular A-P dimension in both systole and diastole (24.3Ϯ2.

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Mitral annuloplasty in patients with ischemic versus dilated cardiomyopathy

Abstract: Mitral reconstruction with a posterior annuloplasty using a flexible ring is effective in patients with severely depressed left ventricle function and has an acceptable operative mortality. Mid-term results are superior to medical treatment alone and comparable to cardiac transplantation.

Cited by 58 publications

References 20 publications

Off Pump Coronary Artery Bypass versus Mitral Annuloplasty in Moderate Ischemic Mitral Regurgitation

Off Pump Coronary Artery Bypass versus Mitral Annuloplasty in Moderate Ischemic Mitral Regurgitation

Isolated Undersized Mitral Annuloplasty for Functional Mitral Regurgitation in Non-Ischemic Dilated Cardiomyopathy Reconsideration of the Relationship Between Preoperative Coaptation Depth and Persistent Mitral Regurgitation

Percutaneous Mitral Valve Repair for Chronic Ischemic Mitral Regurgitation

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