| Comparison of Need for Operative Therapy in Patients With Mitral Valve Prolapse Involving Both Leaflets Versus Posterior Leaflet Only. | |
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MedLine Citation:
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PMID: 22835412 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Mitral valve prolapse may involve 1 leaflet or 2 leaflets, yet management guidelines do not differentiate posterior leaflet (PML) from bileaflet (BML) prolapse. We hypothesized that patients with BML have a prolonged natural history with more severe atrial and ventricular enlargement but less severe mitral regurgitation (MR) compared to patients with PML. Patients with mitral valve prolapse undergoing mitral repair were identified and preoperative characteristics were recorded. Patients with predominant PML prolapse (n = 304) versus BML prolapse (n = 131) were identified based on preoperative echocardiographic and intraoperative findings. Timing of operation was based on standard guidelines. Despite being equally symptomatic, patients with BML differed significantly from those with PML in being younger (54 vs 60 years, p <0.0001), more likely to be women (51% vs 24%, p <0.0001), and having a larger valve (37 vs 32 mm, p <0.0001). Despite similar cardiac function and dimensions, patients with BML had less severe MR (24% vs 13% with <4+ MR, p = 0.01) and less severe pulmonary hypertension (14% vs 31%, p <0.0001) at time of operation. In conclusion, patients with BML often meet indications for mitral valve repair with similar cardiac enlargement but less MR than patients with PML prolapse. Patients with BML prolapse may benefit from timing mitral repair based more on symptomatic 3+ MR or cardiac enlargement and less on presence of severe MR. |
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Authors:
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Asad A Shah; Bhargavi S Desai; Zainab Samad; James G Jollis; Donald D Glower |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-24 |
Journal Detail:
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Title: The American journal of cardiology Volume: - ISSN: 1879-1913 ISO Abbreviation: - Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-7-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Published by Elsevier Inc. |
Affiliation:
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Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke Medical University Center, Durham, North Carolina. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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