Document Detail


Echocardiographic predictors for persistent functional mitral regurgitation after aortic valve replacement in patients with aortic valve stenosis.
MedLine Citation:
PMID:  20723649     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Moderate functional mitral regurgitation (MR) in patients with aortic valve stenosis (AS) is often left unaddressed at the time of aortic valve replacement (AVR) because it is expected to decrease after AVR. However, some patients have persistent moderate MR after AVR. We sought to determine the preoperative echocardiographic predictor for persistent functional MR after AVR in patients with AS. Pre- and postoperative echocardiograms were reviewed in 110 patients with severe AS and functional MR who underwent AVR without mitral valve (MV) surgery. Fifty-eight patients received concomitant coronary artery bypass graft surgery. In patients with MV tenting, defined as apical displacement of mitral leaflets in the apical 4-chamber view, MV tenting area and tenting height were measured at midsystole. Eighty patients had MV tenting (mean MV tenting area 1.4 +/- 0.5 cm(2), mean MV tenting height 0.8 +/- 0.2 cm) and 30 did not have it before AVR. MR severity decreased in 51 of 80 patients (64%) with MV tenting after AVR and in 25 of 30 patients (83%) without MV tenting (p <0.05). In patients with MV tenting, multivariate analysis revealed that presence of long-term atrial fibrillation and MV tenting area were independent predictors of postoperative MR severity (all p values <0.05). The sensitivity and specificity in predicting persistent moderate MR after AVR were 72% and 82% for MV tenting area >1.4 cm(2). In conclusion, preoperative MV tenting predicts persistent functional MR after AVR in patients with severe AS.
Authors:
Yoshiki Matsumura; A Marc Gillinov; Manatomo Toyono; Hiroki Oe; Tetsuhiro Yamano; Kunitsugu Takasaki; Roberto M Saraiva; Takahiro Shiota
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  701-6     Citation Subset:  AIM; IM    
Copyright Information:
2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Medicine, Cleveland Clinic, Ohio, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Valve Stenosis / complications,  therapy*,  ultrasonography*
Bioprosthesis
Cohort Studies
Echocardiography, Doppler, Color*
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation*
Humans
Male
Middle Aged
Mitral Valve Insufficiency / etiology*,  physiopathology,  ultrasonography*
Predictive Value of Tests
Retrospective Studies
Risk Factors
Severity of Illness Index

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


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