The change in the mitral-septal angle after surgery for atrial functional mitral regurgitation

Kaneyuki, Daisuke; Nakajima, Hiroyuki; Asakura, Takeshi; Yoshitake, Akihiro; Tokunaga, Chiho; Tochii, Masato; Hayashi, Jun; Takazawa, Akira; Izumida, Hiroaki; Iguchi, Atsushi

doi:10.1007/s11748-020-01408-0

Cited by 5 publications

(9 citation statements)

References 25 publications

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“…Another previous study reported that mitral valve repair with LA plication can also prevent the narrowing of the postoperative mitral-septal angle, which is a parameter possessing a pathological significance similar to that of the aorto-mitral angle. 20) Patients who experienced post-operative AA events tended to have a higher rate of anterior mitral leaflet prolapse than those who did not, although no statistically significant difference was noted. Further, in the Cox proportional hazards analyses, the anterior mitral leaflet prolapse was not an independent predictor of the post-operative AA events.…”

Section: Discussionmentioning

confidence: 79%

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

et al. 2021

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Section: Discussionmentioning

confidence: 79%

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

et al. 2021

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“…We have previously reported that postoperative cerebrovascular embolism and the need for reoperation were more frequent in patients with LAVI ≥ 142 ml/m 2 4 . Kaneyuki et al 18 suggested that LA plication induces a positive change in the mitral‐septal angle, which is a parameter similar to the AM angle. Matsumori et al 23 used the MV angle to evaluate the negative remodeling of the mitral annulus induced by LA dilatation and demonstrated the efficacy of LA plication for atrial functional MR. Our results are consistent with those of the previous studies.…”

Section: Discussionmentioning

confidence: 93%

“…We have previously reported that postoperative cerebrovascular embolism and the need for reoperation were more frequent in patients with LAVI ≥ 142 ml/m 2 . 4 Kaneyuki et al 18 suggested that LA plication induces a positive change in the mitral-septal angle, which is a parameter similar to the AM angle. Matsumori et al 23…”

Section: Am Angle As a Factor Influencing Cvesmentioning

confidence: 99%

Aortomitral angle affects cardiovascular events after mitral valve repair for atrial functional mitral regurgitation

Abe

Fujii

Morisaki

et al. 2022

Journal of Cardiac Surgery

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Purpose This study aimed to elucidate the geometric parameters of the aortomitral (AM) complex affecting postoperative cardiovascular events (CVEs) in patients with atrial functional mitral regurgitation (MR). Methods From October 2008 to August 2018, we performed mitral and tricuspid valve repairs in 58 patients with atrial functional MR. We examined the determinants of CVEs using preoperative and postoperative echocardiographic data. Furthermore, we analyzed the effect of left atrial (LA) plication on AM geometries after surgery. The follow‐up period ranged from 56 to 3283 days (median, 1073 days). Results All patients underwent mitral and tricuspid annuloplasty. Seventeen patients (29%) underwent additional LA plication. The AM angle was narrowed after surgery in patients with CVEs (115° ± 6.8° to 106° ± 4.2°, p = .00336), whereas it widened in patients without CVEs (115° ± 7.4° to 118° ± 8.4°, p = .0278). The postoperative AM angle was an independent predictor of postoperative CVEs (p = .000829). LA plication was not a predictor of CVEs; however, it was a predictor of the obtuse postoperative AM angle (p = .0071). Conclusions Our results suggest that a narrow postoperative AM angle is an independent predictor of postoperative CVEs. Additional LA plication reduces the sharpening of the AM angle, which may prevent CVEs after mitral valve repair for atrial functional MR.

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“…Sakaguchi et al 7 compared patients with versus without recurrent MR and concluded that mitral annuloplasty alone may not be sufficient to achieve long‐term correction, even though they showed it to be associated with early improvement of clinical symptoms. Kaneyuki et al 18 have recently evaluated the effects of ring annuloplasty and LA plication on the mitral‐septal angle (MSA), which is known to be a risk factor for abnormal vortex pattern when its value is lower than 70° 33 . They showed that the mitral septal angle decreased with a decrease in the mitral annuloplasty ring size, whereas it increased in patients who underwent LA plication.…”

Section: Discussionmentioning

confidence: 99%

“…Vohra et al 15 Takahashi et al 16 Takahashi et al 17 Sakaguchi et al 7 Kaneyuki et al 18 Chen et al 19 Matsumori et al 14 Balogh et al 20 Tanaka et al 13 Hirji et al 21 Carino et al 22 Inclusion criteria Chronic AF Carpentier Type 2…”

Section: Definition Of Afmr: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Variable definitions and treatment approaches for atrial functional mitral regurgitation: A scoping review of the literature

Amabile

Fereydooni

Mori

et al. 2022

Journal of Cardiac Surgery

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Objectives Atrial functional mitral regurgitation (AFMR) is a subtype of functional mitral regurgitation due to longstanding atrial fibrillation (AF) or heart failure with preserved ejection fraction. The variation in AFMR' definition and the common mode of treatment described in the literature remain unknown. Methods We performed a scoping review of studies that surgically treated AFMR to characterize the existing variability in the definition of AFMR, the type of operations performed for AFMR valvulopathy, and the treatment for the chronic AF. We searched Medline, EMBASE, Cochrane Library, Scopus, and Web of Science since their inceptions for studies of patients affected by AFMR and surgically treated for their valvulopathy. Results Twelve studies (n = 494 patients) met eligibility criteria. All studies excluded patients with signs of left ventricular (LV) dysfunction, but the way additional parameters were used to define AFMR at a more granular level varied across studies: nine studies (75%) used the presence of AF to define their AFMR cohorts, with five (41.2%) requiring a history of AF of >1 year; additionally, the threshold values for the LV ejection fraction differed (45%–55%). Isolated mitral annuloplasty was performed in 96.2% of patients. Broad variability was detected in the proportion of patients undergoing the Cox‐Maze procedure (range, 17.8%–79.5%), pulmonary vein isolation (0.0%–66.7%), and left atrial appendage ligation (0.0%–100.0%). Conclusions AFMR remains variably defined in surgical studies, making comparisons across studies difficult. Mitral annuloplasty was most commonly performed. The proportion of AFMR patients undergoing concomitant procedures for AF varied substantially.

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The change in the mitral-septal angle after surgery for atrial functional mitral regurgitation

Cited by 5 publications

References 25 publications

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

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

Aortomitral angle affects cardiovascular events after mitral valve repair for atrial functional mitral regurgitation

Variable definitions and treatment approaches for atrial functional mitral regurgitation: A scoping review of the literature

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