Document Detail


Impact of preoperative left ventricular ejection fraction on postoperative left ventricular remodeling after mitral valve repair for degenerative disease.
MedLine Citation:
PMID:  10888084     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: Mitral valve repair has been associated with better preservation of left ventricular (LV) function, especially in the setting of degenerative regurgitation. The goal of this study was to evaluate the impact of mitral valve repair on postoperative LV ejection fraction (LVEF) and LV remodeling as determined by LV end-systolic and diastolic diameters. METHODS: A prospective echocardiographic and clinical evaluation of 91 patients undergoing mitral valve repair for degenerative regurgitation between 1993 and 1998 was performed. Patients with normal preoperative LVEF (> or = 50%; group 1, n = 71) were compared with patients with decreased preoperative LVEF (< 50%; group 2, n = 20) one year after mitral valve repair. RESULTS: In group 1 patients, the LVEF was preserved at one year, while the LV end-systolic diameter was significantly reduced from 36 +/- 7 mm to 32 +/- 8 mm (p <0.05). There was a significant improvement in LVEF in group 2 patients (38 +/- 6% preoperative versus 50 +/- 12% at one year, p <0.05). The preoperative LV end-systolic diameter was significantly larger in group 2 patients (47 +/- 9 mm) than in group 1 patients (36 +/- 7 mm) (p <0.001), but decreased to normal values at one year after repair (38 +/- 7 mm, p <0.05). CONCLUSION: There was good preservation of LV function after mitral valve repair in group 1 patients. The LVEF significantly increased towards normal in patients with depressed LV function before repair. The LV systolic diameter was restored to normal within one year of repair, even in patients with poor LV function. Decreased preoperative LV function should not be a contraindication to mitral valve repair in patients with degenerative regurgitation.
Authors:
B de Varennes; R Haichin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  9     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-10-27     Completed Date:  2000-10-27     Revised Date:  2006-05-04    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  313-8; discussion 318-20     Citation Subset:  IM    
Affiliation:
Division of Cardio-Thoracic Surgery, McGill University Health Center, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Case-Control Studies
Echocardiography
Echocardiography, Transesophageal
Female
Humans
Male
Middle Aged
Mitral Valve / surgery*
Mitral Valve Insufficiency / physiopathology,  surgery*,  ultrasonography
Postoperative Period
Stroke Volume / physiology*
Ventricular Dysfunction, Left / physiopathology*,  ultrasonography
Ventricular Remodeling / physiology*

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


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