Document Detail


Functional ischemic mitral regurgitation in anterior ventricular remodeling: results of surgical ventricular restoration with and without mitral repair.
MedLine Citation:
PMID:  15886977     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ischemic functional mitral regurgitation following ischemic cardiomyopathy is a secondary phenomenon to ventricular dilation, and therapeutic approaches to this complication are not uniform. Solutions to improve mitral function include either mitral repair or observing the effects of coronary revascularization and/or ventricular rebuilding during surgical ventricular restoration (SVR). The present study of 108 patients (comprising 18% of our 588 SVR population) reports the effects of mitral repair following SVR and CABG by comparing geometric, functional, hemodynamic and outcome changes to SVR patients without mitral repair. The degree of mitral regurgitation went from 2.9 +/- 1.2 before to 0.7 +/- 0.7 after SVR and mitral repair. SVR improved EF from 29 +/- 7% to 34 +/- 10% p 0.001; reduced end diastolic volume from 243 +/- 74 to 163 +/- 53 ml and end systolic volume from 170 +/- 63 to 107 +/- 41 ml, p 0.000. Ventricular size and shape geometric measurements improved in all patients, either with and without mitral repair. SVR improved tenting and papillary muscle width between muscle heads in all patients, but alterations in mitral annular size improved only following mitral repair. Preoperative mitral regurgitation occurred in patients with larger ventricular volume and lower ejection fraction and was an independent predictor of operative mortality risk.
Authors:
L Menicanti; M DiDonato; S Castelvecchio; C Santambrogio; V Montericcio; A Frigiola; G Buckberg;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart failure reviews     Volume:  9     ISSN:  1382-4147     ISO Abbreviation:  Heart Fail Rev     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2005-05-11     Completed Date:  2005-10-04     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  9612481     Medline TA:  Heart Fail Rev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  317-27     Citation Subset:  IM    
Affiliation:
San Donato Hospital, Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Cardiac Surgical Procedures*
Coronary Artery Bypass
Hemodynamics / physiology
Humans
Logistic Models
Mitral Valve Insufficiency / etiology,  physiopathology*,  surgery*
Myocardial Ischemia / complications,  physiopathology,  surgery
Papillary Muscles / physiopathology,  surgery
Suture Techniques
Treatment Outcome
Ventricular Dysfunction, Left / complications,  physiopathology*,  surgery*
Ventricular Remodeling / physiology*

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


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