Document Detail


Clinical, echocardiographic, and biomechanical differences in mitral valve prolapse affecting one or both leaflets.
MedLine Citation:
PMID:  12062734     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mitral valve prolapse (MVP) is the most common cause of severe mitral regurgitation necessitating surgical correction. Unileaflet prolapse (ULP), usually involving the posterior leaflet, is more common than bileaflet prolapse (BLP), which is more difficult to repair. Little is known about clinical, echocardiographic, and biomechanical differences between ULP and BLP. In this study, biomechanical testing was performed on mitral valve leaflets and chordae obtained at operation for severe mitral regurgitation. Preoperative clinical characteristics and echocardiographic measurements were obtained on surgical patients (ULP = 88, BLP = 37). Men outnumbered women by a factor of 4:1 in ULP, and by 3:1 in BLP. Patients with BLP were younger (53.2 +/- 1.7 vs 59.5 +/- 1.1 years) than those with ULP, and this difference was greater in women (48.9 +/- 2.5 vs 62.9 +/- 2.2 years). BLP patients were less likely to be hypertensive, and more likely to undergo valve replacement rather than repair. Echocardiography showed that BLP leaflets were longer and thicker than ULP leaflets. The severity of mitral regurgitation was similar in both groups, although ULP patients had a much higher incidence of flail leaflets (45% vs 5% in BLP). Mechanical strength of chordae was greater in BLP than in ULP, although leaflet strength was similar. The increased chordal strength in BLP may be responsible for less flail. In patients with MVP and severe mitral regurgitation requiring surgery, ULP and BLP are distinct entities with substantial differences in the population affected, in echocardiographic manifestations including prevalence of flail, in chordal mechanics, and in the likelihood of surgical repair.
Authors:
William R Mills; J Edward Barber; Jeffery A Skiles; Norman B Ratliff; Delos M Cosgrove; Ivan Vesely; Brian P Griffin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  89     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-13     Completed Date:  2002-07-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1394-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Biomechanics
Chi-Square Distribution
Echocardiography, Doppler, Color
Female
Humans
Male
Middle Aged
Mitral Valve Insufficiency / etiology,  surgery
Mitral Valve Prolapse / classification,  complications,  physiopathology*,  ultrasonography*
Risk Factors
Statistics, Nonparametric
Tensile Strength

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


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