Mitral valve gradient after valve repair of degenerative regurgitation with restrictive annuloplasty

Murashita, Takashi; Greason, Kevin L.; Suri, Rakesh M.; Daly, Richard C.; Joyce, Lyle D.; Stulak, John M.; Pochettino, Alberto; Joyce, David L.; Dearani, Joseph A.; Schaff, Hartzell V.

doi:10.1016/j.jtcvs.2015.08.078

Cited by 19 publications

(15 citation statements)

References 10 publications

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“…In this study, the mean postoperative MG of 3.1 mm Hg was comparable with those in previous studies. 14 Moreover, the mean prosthetic size of 29.1, despite being seemingly smaller than those in previous studies, became acceptable after being indexed by the relatively small body surface areas. Our results were consistent with previous studies, in which full ring annuloplasty and smaller prosthetic size were associated with elevated PTMGs.…”

Section: Discussionmentioning

confidence: 70%

Elevated gradient after mitral valve repair: The effect of surgical technique and relevance of postoperative atrial fibrillation

Shi

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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Objectives: We sought to investigate the effect of surgical technique in mitral valve repair on postoperative transmitral gradient (PTMG) and the relationship between PTMG and postoperative atrial fibrillation (AF).Methods: In this retrospective study, 390 patients who underwent mitral valve repair for degenerative mitral regurgitation without AF were included. PTMG was measured using transthoracic echocardiography before patient discharge. At follow-up, occurrences of AF within 6 months of surgery (early AF) and 6 months after surgery (late AF), as well as clinical and echocardiographic data were documented and investigated.

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Section: Discussionmentioning

confidence: 70%

Elevated gradient after mitral valve repair: The effect of surgical technique and relevance of postoperative atrial fibrillation

Shi

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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“…Although the optimal choice of annuloplasty ring type continues to be debated, the present study suggests that full ring is the optimal choice for anterior prolapse. Several studies have examined the effect of annuloplasty type on repair durability, left ventricular function, and functional mitral stenosis after primary mitral repair, 23 but the structure of the prosthesis applied has not been extensively discussed. Spiegelstein and colleagues 6 reported that the use of open annuloplasty rings is an independent predictor of late recurrence of moderate or severe mitral regurgitation.…”

Section: Discussionmentioning

confidence: 99%

Should annuloplasty prosthesis be selected dependent on the location of prolapse in mitral valve repair for type II dysfunction?

Kawamoto

Fujita

Fukushima

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

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“…Previous studies have reported that, compared to partial rings, complete rings may be associated with higher MV gradients 16 . Another report also supports the concept that restrictive annuloplasty results in small valve gradients 15 . However, in our cohort, only the iTEE MPG values were higher in the total annuloplasty group, and only the post-TTE MPG values were higher in the partial annuloplasty group.…”

Section: Discussionmentioning

confidence: 54%

Comparing intraoperative transesophageal and postoperative transthoracic echocardiography findings in mitral valve surgery: what changes?

Alves,

Branco,

Marinho

et al. 2019

Preprint

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OBJECTIVES Intraoperative transesophageal echocardiography (iTEE) has an important role in diagnosing the results of mitral valve (MV) replacement and repair. However, intraoperative Doppler features may be dissimilar from those measured at the postoperative follow-up period due to hemodynamic variations. There are no studies regarding MV surgery and comparisons between iTTE and postoperative transthoracic echocardiography (post-TTE). We aimed to evaluate the Doppler flow profiles observed in iTEE after MV replacement and repair and compare them with those observed in post-TTE. METHODS We conducted an observational study of 76 patients who underwent MV surgery (replacement or repair) over a 10-month period. iTEE was performed with Doppler evaluation (mean pressure gradient [MPG] and functional area). Patients were re-evaluated with TTE 72 hours after surgery (post-TTE). iTEE and post-TTE Doppler values were then compared and correlated. RESULTS The patients' mean age was 59 ± 18 years and 55% were women. The prevalence of severe mitral regurgitation and severe mitral stenosis was 77.6% and 22.4%, respectively. MV repair was performed in 71% of cases. iTEE Doppler parameters correlated with post-TTE parameters, with minimal differences, specially in the MV repair group. The postoperative MPG was +0.4 ± 1 mmHg higher in the MV repair group and +1.0 ± 1.8 mmHg in the MV replacement group. There was global improvement in terms of systolic pulmonary artery pressure, although left ventricular ejection fractions were slightly reduced during the postoperative evaluation. CONCLUSIONS Our study demonstrates the usefulness of iTEE and its importance in establishing possible reference values for postoperative follow-ups.

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Mitral valve gradient after valve repair of degenerative regurgitation with restrictive annuloplasty

Abstract: Mitral valve repair for degenerative regurgitation results in a small mitral valve gradient that appears to decrease with time after discharge.

Cited by 19 publications

References 10 publications

Elevated gradient after mitral valve repair: The effect of surgical technique and relevance of postoperative atrial fibrillation

Elevated gradient after mitral valve repair: The effect of surgical technique and relevance of postoperative atrial fibrillation

Should annuloplasty prosthesis be selected dependent on the location of prolapse in mitral valve repair for type II dysfunction?

Comparing intraoperative transesophageal and postoperative transthoracic echocardiography findings in mitral valve surgery: what changes?

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