Abstract
The progression of left ventricular (LV) remodeling and subsequent mitral valve tethering impair the results of reduction annuloplasty for ischemic mitral regurgitation (MR). We studied 90 patients who underwent surgical repair of ischemic MR between 1999 and 2013 according to our surgical strategy adding submitral and ventricular procedures to annuloplasty as follows: annuloplasty alone (stage 1, n = 30), additional papillary muscle approximation (PMA) for progression of tethering (stage 2, n = 26), and additional left ventriculoplasty with PMA for progression of LV remodeling and tethering (stage 3, n = 34). The preoperative New York Heart Association (NYHA) functional classes (2.5 ± 0.7, 3.1 ± 0.7 and 3.3 ± 0.7 for stages 1, 2 and 3, respectively, P <0.001), LV end-diastolic diameters (56 ± 7 mm, 66 ± 5 mm and 70 ± 7 mm, P <0.001), and LV ejection fractions (45 ± 12%, 32 ± 9% and 27 ± 9%, P <0.001) significantly differed among the stages. In contrast, the MR grades did not significantly differ (2.9 ± 0.8, 3.0 ± 1.0, and 2.9 ± 1.1, respectively; P = 0.93). Both the rates of cardiac-related survival and freedom from reoperation were comparable among the 3 groups (log-rank P = 0.92 and 0.58, respectively). Additional submitral ...Continue Reading
References
Jun 1, 1995·American Heart Journal·D S Bach, S F Bolling
Apr 3, 2001·Circulation·F GrigioniA J Tajik
Aug 9, 2002·The Journal of Thoracic and Cardiovascular Surgery·Yoshiro MatsuiKeishu Yasuda
Aug 14, 2002·The Annals of Thoracic Surgery·Irving L KronJeffrey T Cope
Mar 21, 2003·The Annals of Thoracic Surgery·Ulrik HvassAbdel Shafy
Feb 1, 2005·The Annals of Thoracic Surgery·Atsushi YamaguchiTakashi Ino
Aug 3, 2005·Circulation·Robert A Levine, Ehud Schwammenthal
Jun 5, 2007·Journal of the American College of Cardiology·Tomislav MihaljevicBruce W Lytle
Aug 3, 2007·Interactive Cardiovascular and Thoracic Surgery·Mohammad Hossein MandegarMehrab Marzban
Jan 29, 2008·The Annals of Thoracic Surgery·Jerry BraunRobert A E Dion
Nov 20, 2008·Journal of Cardiac Surgery·Akhtar RamaIradj Gandjbakhch
Mar 31, 2009·The New England Journal of Medicine·Robert H JonesUNKNOWN STICH Hypothesis 2 Investigators
May 23, 2009·Circulation Journal : Official Journal of the Japanese Circulation Society·Hisayoshi Suma
Sep 24, 2009·Circulation·Frank LangerHans-Joachim Schäfers
Jan 29, 2010·The Journal of Thoracic and Cardiovascular Surgery·Ulrik Hvass, Thomas Joudinaud
May 4, 2010·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Patrizio LancellottiUNKNOWN European Association of Echocardiography
Aug 24, 2010·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Christina M VassilevaStephen Hazelrigg
Feb 24, 2011·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Mohammad Hossein MandegarFarideh Roshanali
Nov 5, 2011·The Journal of Thoracic and Cardiovascular Surgery·Khalil FattouchGiovanni Ruvolo
Jul 13, 2012·Circulation Journal : Official Journal of the Japanese Circulation Society·Hiromi NakaiYutaka Otsuji
Sep 18, 2013·The Journal of Thoracic and Cardiovascular Surgery·Antonio M CalafioreMichele Di Mauro
Citations
Nov 28, 2015·Interactive Cardiovascular and Thoracic Surgery·Christos G Mihos, Orlando Santana
May 21, 2016·Journal of the American College of Cardiology·Francesco NappiMassimo Chello
Jul 30, 2016·Perfusion·Leonidas V AthanasopoulosThanos Athanasiou
Jun 24, 2017·Interactive Cardiovascular and Thoracic Surgery·Leonidas V AthanasopoulosThanos Athanasiou
Aug 15, 2017·Heart and Vessels·Koji FurukawaKunihide Nakamura
Mar 15, 2018·Heart·Eva Karolina HarmelEvaldas Girdauskas
Apr 22, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Jonas PauschEvaldas Girdauskas
Aug 16, 2016·European Heart Journal Cardiovascular Imaging·Olivier VillemainEmmanuel Messas
Mar 14, 2018·The Journal of Cardiovascular Surgery·Jonathan RilingerMatthias Siepe
Jan 18, 2020·Journal of Cardiac Surgery·Linda R MicaliSandro Gelsomino
Mar 12, 2020·Journal of Cardiac Surgery·Massimo MecoMattia Glauber
Jan 4, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Christos G MihosOrlando Santana
Sep 20, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Annelieke H J PetrusJerry Braun
Aug 19, 2017·Perfusion·Marco MoscarelliKhalil Fattouch