Document Detail


Clinical significance of mitral leaflet flail.
MedLine Citation:
PMID:  19387963     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There has been scant academic consideration paid to investigations of mitral leaflet flail in terms of clinical profile, surgical strategy, and surgical outcome. METHODS: One hundred consecutive patients with mitral leaflet flail referred for surgical treatment in the past 4(2/3) years were included in this study. RESULTS: The most common reasons leading to mitral leaflet flail were chord rupture (38%), myxomatous degeneration (23%), and combined chord rupture and myxomatous degeneration (12%). Mitral leaflet flail was predominantly characterized by independent P(2) flail, followed by P(2,3) flail and independent A(2) flail. Chord rupture occurred in 54 patients, and the most commonly involved segments were P(2), P(2,3), and P(3). The most common risk factors for mitral valve replacement were papillary muscle rupture, extensive myxomatous degeneration, extensive chord rupture, and severely dilated mitral valve annulus. Multivariate regression analyses demonstrated that the development of mitral leaflet flail was significantly associated with the pertinent variables tested, especially correlated with insertion of the prosthetic ring, number of artificial chord, and presence of carotid stenosis. CONCLUSIONS: Mitral leaflet flail may affect patients of any age, but is more prevalent among males and younger patients. Mitral chord rupture was the leading cause for mitral leaflet flail. Myxomatous degeneration, infective endocarditis, mitral annulus calcification, and papillary muscle rupture were the next most common causes. An increased incidence of mitral leaflet flail was closely related to the chords of the posterior leaflet and the middle scallop. Due to the progressive disappointing prognosis of mitral leaflet flail, surgery should be performed at an early stage.
Authors:
Shi-Min Yuan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiology journal     Volume:  16     ISSN:  1897-5593     ISO Abbreviation:  -     Publication Date:  2009  
Date Detail:
Created Date:  2009-04-23     Completed Date:  2009-06-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  151-6     Citation Subset:  IM    
Affiliation:
Department of Cardiac and Thoracic Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel. shi_min_yuan@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Calcinosis / complications
Chordae Tendineae / injuries
Endocarditis / complications
Female
Heart Rupture / complications
Heart Valve Prosthesis Implantation
Humans
Male
Middle Aged
Mitral Valve* / surgery,  ultrasonography
Mitral Valve Insufficiency* / etiology,  surgery,  ultrasonography
Odds Ratio
Papillary Muscles / injuries
Retrospective Studies
Risk Assessment
Risk Factors
Sex Factors
Treatment Outcome

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


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