Pulmonary arterial pressure detects functional mitral stenosis after annuloplasty for primary mitral regurgitation: An exercise stress echocardiographic study

Abstract

The RMA for degenerative MR was associated with a functional stenosis and the PAP at rest and at peak exercise discriminated low exercise capacity.

The Impact of Aorto-Mitral Angle on New-Onset Atrial Arrhythmia after Mitral Valve Repair in Patients with Mitral Regurgitation

“…Exercise stress tests can diagnose patients with subclinical functional MS after mitral valve repair by determining the effective orifice area index and pulmonary arterial pressure that are associated with exercise capacity. 13,14) Otherwise, assessments of follow-up echocardiographic data may be required to prove the association among the aortomitral angle, TMPG, LA size, and AA events. In addition, several other explanations for the negative effect of a small aorto-mitral angle have been reported in previous studies.…”

The Predictors and Outcomes of Functional Mitral Stenosis following Surgical Mitral Valve Repair: A Retrospective Analysis

“…Although using a complete ring has 2 of 16 been associated with a lower MR recurrence rate than a partial band or no annuloplasty at all [11][12][13], it also results in a higher incidence of functional mitral stenosis (FMS) [14,15]. FMS, primarily caused by restrictive annuloplasty, is associated with inferior exercise tolerance, failed left atrial remodeling, new-onset atrial fibrillation (Af), elevated pulmonary artery pressure, residual tricuspid regurgitation (TR), and poor long-term prognosis [16][17][18][19][20].…”

“…FMS is defined as a resting mean trans-mitral pressure gradient (TMPG) of >5 mmHg or MV area of <1.5 cm 2 at rest [20,21], and a mean TMPG of >15 mmHg and pulmonary artery systolic pressure of >60 mmHg during exercise [22]. Previous studies [23,24] have indicated that the use of rigid or undersized rings may increase the risk of a smaller subsequent MV area, leading to FMS.…”