Document Detail


Mitral valve repair for ischemic mitral insufficiency.
MedLine Citation:
PMID:  1755677     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Over a 5-year period, 1,292 patients had operation on their native mitral valves. Ischemia was the cause of mitral insufficiency in 84 patients (6.5%). Sixty-five patients (77.4%) had mitral valve repair. Mean age was 66 +/- 10 years; 35 patients (53.8%) were women. Mean degree of preoperative insufficiency was 3.2 +/- 0.7; mean preoperative New York Heart Association functional class was 3.3 +/- 0.7. Eleven patients (16.9%) had acute and 54 (83.1%) had chronic mitral insufficiency. Valve prolapse was present in 26 patients (40%). Restrictive leaflet motion secondary to regional or global left ventricular dilatation occurred in 39 patients (60%). All patients had associated myocardial revascularization followed by transatrial valvuloplasty. Multiple techniques were employed to achieve valve competence: leaflet resection (3), chordal shortening (15), papillary muscle reimplantation (10), papillary muscle shortening (3), and annuloplasty (63). There were six (9.2%) hospital deaths (acute, 9.1%; chronic, 9.3% [not significant]; prolapse, 11.5%; restrictive, 7.7% [not significant]). The mean degree of postoperative mitral insufficiency was 0.6 +/- 0.8 in 51 patients. At a mean follow-up of 3.1 +/- 1.6 years, patient survival was 96% for patients with valve prolapse and 48% for those with restrictive leaflet motion (p = 0.02). New York Heart Association functional class was improved in all groups. Ischemic mitral insufficiency is an uncommon cause of mitral valve disease that is amenable to repair in the majority of cases of both acute and chronic onset. The operative mortality is low, and operation is associated with superior survival in patients with valve prolapse.
Authors:
W G Hendren; J J Nemec; B W Lytle; F D Loop; P C Taylor; R W Stewart; D M Cosgrove
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  52     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1992-01-27     Completed Date:  1992-01-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1246-51; discussion 1251-2     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, OH 44195-5066.
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MeSH Terms
Descriptor/Qualifier:
Aged
Evaluation Studies as Topic
Female
Follow-Up Studies
Heart Valve Prosthesis
Humans
Male
Middle Aged
Mitral Valve / surgery*
Mitral Valve Insufficiency / mortality,  surgery*
Mitral Valve Prolapse / mortality,  surgery
Comments/Corrections
Comment In:
Ann Thorac Surg. 1992 Jul;54(1):190-1   [PMID:  1610245 ]

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


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