| Mitral annuloplasty with IMR ETlogix ring for ischemic mitral regurgitation and left ventricular dysfunction. | |
| | |
MedLine Citation:
|
PMID: 23167218 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
|
BACKGROUND AND AIM OF THE STUDY: Chronic ischemic mitral regurgitation (IMR) is associated with asymmetric mitral leaflet tethering and annular dilation. The Carpentier-McCarthy-Adams IMR ETlogix annuloplasty ring is designed specifically to treat these asymmetric pathological changes. In the present study, the results of mitral annuloplasty with this ring in a selected subset of patients with significant IMR and left ventricular (LV) dysfunction were analyzed. METHODS: Between May 2005 and September 2009, the IMR ETlogix ring was implanted in 140 consecutive patients with grade > OR = 2+ IMR (graded from 0 to 3+). Of these patients, 41 (29%) suffered from preoperative LV dysfunction (defined as LV ejection fraction < OR = 0.35). Ten of these 41 patients underwent combined aortic valve replacement or LV restoration, and thus were excluded from this retrospective study; consequently, 31 patients (mean age 67.1 +/- 7.7 years) were enrolled into the study. Preoperatively, 18 patients (58%) were in NYHA class III or IV, and 16 (52%) were in CCS class 3 or 4. The expected operative risk according to the logistic EuroSCORE was 22.4 +/- 16.5%. Using two-dimensional echocardiography, postoperative changes in the mitral annular diameter (MAD), tethering area (TA), and tenting height (TH) of the mitral valve in four-chamber, two-chamber, and long-axis views, were assessed at mid-systole. RESULTS: All patients underwent complete myocardial revascularization. One (3%) in-hospital (non-cardiac) death occurred. During a mean follow up of 3.4 +/- 1.5 years (range: 0.2 to 5.9 years), one early mitral replacement was required (due to endocarditis), and there were two cardiac deaths and three non-cardiac deaths. The four-year actuarial survival and freedom from heart failure hospital readmission were 82% and 75%, respectively. Heart failure symptoms were improved (p = 0.001), and IMR was well controlled within grade 1+ (p < 0.0001) for the 24 remaining patients. The MAD, TA and TH were each decreased in all three echocardiographic views (p < OR = 0.0006). The MAD reduction was greater in the long-axis view than in the four-chamber (56% versus 49%, p = 0.002) and two-chamber (56% versus 43%, p = 0.0003) views. CONCLUSION: In selected patients with chronic ischemic LV dysfunction, mitral annuloplasty with the IMR ETlogix ring, combined with complete myocardial revascularization, restored the mitral apparatus geometry and competence. |
| | |
Authors:
|
Giuseppe Gatti; Bruno Pinamonti; Luca Dellangela; Francesco Antonini-Canterin; Bernardo Benussi; Gianfranco Sinagra; Aniello Pappalardo |
Related Documents
:
|
3155588 - Electrocardiographic diagnosis of left ventricular hypertrophy in the presence of left ... 15848218 - Heterogeneous expression of connexin 43 in the myocardium of rabbit right ventricular o... 7523788 - Effect of isradipine and nifedipine on diastolic function in patients with left ventric... 16557108 - Effect of a flexible ventricular restraint device on cardiac remodeling after acute myo... 11808838 - Cardiac amyloidosis presenting with elevations of cardiac troponin i and angina pectoris. 7020978 - Ventricular septal rupture: a review of clinical and physiologic features and an analys... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The Journal of heart valve disease Volume: 21 ISSN: 0966-8519 ISO Abbreviation: J. Heart Valve Dis. Publication Date: 2012 Sep |
Date Detail:
|
Created Date: 2012-11-21 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9312096 Medline TA: J Heart Valve Dis Country: England |
Other Details:
|
Languages: eng Pagination: 556-63 Citation Subset: IM |
Affiliation:
|
Divisions of Cardiac Surgery, AOU Ospedali Riuniti, Trieste, Italy. gius.gatti@gmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Factors predicting emergency surgery in severe mitral regurgitation following mitral balloon valvoto...
Next Document: The impact of percutaneous coronary intervention on ischemic mitral regurgitation.