Document Detail

Initial results of posterior leaflet extension for severe type IIIb ischemic mitral regurgitation.
MedLine Citation:
PMID:  19451349     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Management of severe ischemic mitral regurgitation remains difficult with disappointing early and intermediate-term surgical results of valve repair. METHODS AND RESULTS: Forty-four patients with severe (4+) Carpentier type IIIb ischemic mitral regurgitation underwent mitral valve repair, with or without surgical revascularization, by posterior leaflet extension with a patch of bovine pericardium and a remodeling annuloplasty. Serial echocardiography was performed preoperatively, intraoperatively, and postoperatively to assess mitral valve competence. The postoperative functional status of patients was assessed. The average Parsonnet score was 38+/-13. Thirty-day mortality was 11%, and late mortality was 14%. Mean follow-up was 38 months. The actuarial freedom from moderate or severe recurrent mitral regurgitation was 90% at 2 years, whereas 90% of patients were in New York Heart Association class I at 2 years. CONCLUSIONS: Posterior leaflet extension with annuloplasty of the mitral valve for severe type IIIb ischemic regurgitation is a safe, effective method that provides good early and intermediate-term competence of the mitral valve and therefore good functional status.
Benoit de Varennes; Rakesh Chaturvedi; Surita Sidhu; Annie V C?t?; William Li Pi Shan; Caroline Goyer; Roupen Hatzakorzian; Jean Buithieu; Allan Sniderman
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-05-18
Journal Detail:
Title:  Circulation     Volume:  119     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-02     Completed Date:  2009-06-25     Revised Date:  2010-03-02    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2837-43     Citation Subset:  AIM; IM    
McGill University Health Center, Montreal, Quebec, Canada.
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MeSH Terms
Aged, 80 and over
Aortic Valve / surgery
Echocardiography, Doppler, Color
Follow-Up Studies
Internal Mammary-Coronary Artery Anastomosis
Middle Aged
Mitral Valve / surgery*,  ultrastructure
Mitral Valve Insufficiency / etiology,  surgery*,  ultrasonography
Myocardial Infarction / complications*,  surgery
Postoperative Complications / mortality
Prostheses and Implants
Retrospective Studies
Suture Techniques
Treatment Outcome
Tricuspid Valve / surgery
Ventricular Function, Left
Comment In:
Circulation. 2009 Jun 2;119(21):2755-7   [PMID:  19451345 ]
Circulation. 2010 Feb 16;121(6):e36   [PMID:  20159839 ]

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