Document Detail


Echocardiographic predictors of successful versus unsuccessful mitral valve repair in ischemic mitral regurgitation.
MedLine Citation:
PMID:  16893706     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mitral valve (MV) annuloplasty is the standard surgical technique for the management of ischemic mitral regurgitation (MR). However, < or = 1/3 of patients develop recurrent MR after annuloplasty. Therefore, we sought to identify the preoperative echocardiographic parameters that predict annuloplasty failure in patients with ischemic MR. Intraoperative transesophageal echocardiograms from 365 patients who underwent MV repair for ischemic MR were reviewed. Of the 365 patients, 297 (81%) had satisfactory outcomes with < 2+ MR, and 68 (19%) had recurrent MR (> or = 2+) during a mean follow-up of 269 days. The mitral annular parameters, including mitral annular diameter, tethering height, and tethering area of the mitral leaflets, were determined in 3 different echocardiographic views. On multiple logistic stepwise regression analysis, a higher mitral annular diameter, higher tethering area, and higher MR severity were identified as independent predictors for failure of MV repair (p < 0.0001). In conclusion, these results demonstrated that preoperative echocardiographic findings can be used to identify patients with ischemic MR at increased risk of repair failure. These echocardiographic measurements should be used to guide the cardiologist and cardiac surgeon in the choice of MV repair versus replacement in patients with ischemic MR.
Authors:
Vorachai Kongsaerepong; Maiko Shiota; A Marc Gillinov; Jong-Min Song; Shota Fukuda; Patrick M McCarthy; Timothy Williams; Robert Savage; Masao Daimon; James D Thomas; Takahiro Shiota
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-06-21
Journal Detail:
Title:  The American journal of cardiology     Volume:  98     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-08     Completed Date:  2006-09-21     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:  504-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cardiac Surgical Procedures / methods*
Echocardiography, Transesophageal*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Mitral Valve / surgery*,  ultrasonography
Mitral Valve Insufficiency / complications,  surgery,  ultrasonography*
Myocardial Ischemia / complications,  ultrasonography*
Observer Variation
Prognosis
Retrospective Studies

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


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