1993
DOI: 10.1016/s0022-5223(19)34226-6
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Pathogenesis of ischemic mitral insufficiency

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Cited by 70 publications
(22 citation statements)
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“…Several experimental animal studies indicated that most of the acute IsMR occur as the result of early systolic incomplete mitral leaflet coaptation in the central regions of the leaflets, which predominantly occurs as a consequence of mitral annulus dilation. 17,18 In addition to acute mitral annulus dilation, chronic IsMR is associated with structural and shape changes of the left ventricle where the relationship between mitral annular area and IsMR is even more important. 19 Recent reports indicated that a reduction in MAA significantly changes sphericity of the left ventricle 24 months after surgery, and could have an effect of "slow auto remodeling" of the left ventricle.…”
Section: Discussionmentioning
confidence: 99%
“…Several experimental animal studies indicated that most of the acute IsMR occur as the result of early systolic incomplete mitral leaflet coaptation in the central regions of the leaflets, which predominantly occurs as a consequence of mitral annulus dilation. 17,18 In addition to acute mitral annulus dilation, chronic IsMR is associated with structural and shape changes of the left ventricle where the relationship between mitral annular area and IsMR is even more important. 19 Recent reports indicated that a reduction in MAA significantly changes sphericity of the left ventricle 24 months after surgery, and could have an effect of "slow auto remodeling" of the left ventricle.…”
Section: Discussionmentioning
confidence: 99%
“…Even more, the failure of the repair demands to perform mitral replacement and the decision between a mechanical valve and a bioprosthesis should be discussed with the patient before the operation. The presence of systolic restricted leaflet motion on the remaining leaflets (type III-b) and some degree of annular dilatation (functional type I) might also be present emphasizing the initial geometric disorder often difficult to solve (23,63).…”
Section: Patient Carementioning
confidence: 99%
“…There is frequently asymmetrical dilation of the annulus and failure of contraction of the papillary muscle(s) and the adjacent myocardium. 6 This results in decreased movement of the tips of the papillary muscles toward the center of the annulus during systole, resulting in leaflet malcoaptation. Patients with functional MR and symptomatic heart failure are frequently higher-risk candidates for operative intervention/repair because of serious associated myocardial dysfunction.…”
Section: Current Surgical Optionsmentioning
confidence: 99%