Document Detail


Anterior mitral leaflet length: predictor for mitral valve repair in a rheumatic population.
MedLine Citation:
PMID:  21095338     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The length and mobility of the anterior mitral leaflet (AML) are considered important for mitral valve reparability. In this study, we looked at AML length as a predictor of mitral valve reparability in a rheumatic population.
METHODS: Between May and November 2008, 44 patients underwent mitral valve repair for pure mitral regurgitation, pure mitral stenosis, and mixed lesions. The mean age was 26.5 ± 10.4 years (range, 9 to 50; median 23.5), and 15 patients were less than 20 years old. There were 28 female patients. The mean body surface area was 1.37 ± 0.13 (range, 0.97 to 1.62). In all patients, we measured AML length at the A2 segment, both by transesophageal echocardiography and intraoperative direct measurement. These measurements were indexed to the body surface area.
RESULTS: Thirty-five patients had successful repair. Nine patients underwent mitral valve replacement after failed repair. The AML lengths were significantly higher in the successful repair group as compared with the failed repair group (AML length measured by transesophageal echocardiography was 31.4 ± 4.9 mm versus 24.1 ± 2.2 mm, p = 0.001; AML length measured intraoperatively was 30.8 ± 4.4 mm versus 22.3 ± 1.5 mm, p = 0.001). An intraoperatively measured AML length of 26 mm or more predicts reparability with 97.1% sensitivity and 100% specificity. Transesophageal echocardiography can reliably judge AML length and can also predict reparability. Indexed AML lengths are an even stronger predictor of mitral valve reparability, especially in a pediatric population.
CONCLUSIONS: Indexed AML length is a strong predictor of mitral valve reparability. With a value of 18 mm/m(2) or more, repair can be accomplished in all cases.
Authors:
Anubhav Gupta; Parag Gharde; Arkalgud Sampath Kumar
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1930-3     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiovascular and Thoracic Surgery, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Diagnosis, Differential
Echocardiography, Transesophageal / methods*
Female
Heart Valve Diseases / surgery,  ultrasonography*
Heart Valve Prosthesis Implantation / methods*
Humans
Male
Middle Aged
Mitral Valve / surgery,  ultrasonography*
ROC Curve
Retrospective Studies
Rheumatic Heart Disease / surgery,  ultrasonography*
Severity of Illness Index
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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