| Posterior pericardial annuloplasty in ischemic mitral regurgitation. | |
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MedLine Citation:
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PMID: 19833596 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Ischemic mitral regurgitation (IMR) is an important risk factor in coronary artery bypass grafting (CABG) operations. The decision to perform concomitant mitral annuloplasty along with the CABG depends on the surgeon's choice. The aim of this study was to evaluate the results of posterior annuloplasty procedures with autologous pericardium performed in patients with midadvanced and advanced functional ischemic mitral regurgitation. METHODS: Study participants were 36 patients with IMR (mean age 59 +/- 10 years) who underwent posterior pericardial annuloplasty and CABG operations between 2002 and 2007. Preoperative and postoperative (mean follow-up 18 +/- 1 months) MR grade, left atrium diameter, left ventricle end systolic diameter, left ventricle end diastolic diameter, left ventricle ejection fraction, and mitral valve gradients were measured with transthoracic echocardiography. RESULTS: There was one late mortality (2, 8%) but none of the patients required reoperation for residual MR. We did not observe thromboembolism, bleeding, or infective endocarditis. The mean MR grade decreased from 3.4 +/- 0.5 to 0.5 +/- 0.6 (P < .01), left atrium diameter decreased from 45.3 +/- 5.5 mm to 43.2 +/- 3.8 mm (P < .01), left ventricle end diastolic diameter decreased from 53.2 +/- 5.6 mm to 50.9 +/- 5.5 mm (P < .01), and left ventricle end systolic diameter decreased from 39.7 +/- 5.8 mm to 34.6 +/- 6.5 mm (P < .01), whereas mean left ventricle ejection fraction increased from 37.9% +/- 6.1% to 43.7% +/- 7.3% (P < .01). In the late postoperative term, the functional capacity of the patients increased from mean New York Heart Association class 2.6 +/- 0.9 to 1.1 +/- 0.5. We did not observe any gradient in the mitral valve preoperatively in any patient, but in the follow-up, the mean gradient increased to 1.3 +/- 2.1 mmHg (P < .01). CONCLUSION: Posterior pericardial annuloplasty with CABG in the treatment of IMR provides efficient mitral repair and significant decrease in the left atrium and left ventricle diameters, and provides a significant increase in left ventricular function. These results show IMR to be as effective as the other annuloplasty techniques. IMR is performed with autologous material and therefore does not entail any risk of complications from prosthetic material and is highly cost-effective. |
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Authors:
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Oguz Omay; Emre Ozker; Cenk Indelen; Murat Baskurt; Kaya Suzer; Ilhan Gunay |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The heart surgery forum Volume: 12 ISSN: 1522-6662 ISO Abbreviation: Heart Surg Forum Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-16 Completed Date: 2010-01-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100891112 Medline TA: Heart Surg Forum Country: United States |
Other Details:
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Languages: eng Pagination: E285-90 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery, Baskent University, Istanbul, Turkey. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cardiac Volume Combined Modality Therapy Coronary Artery Bypass* Female Humans Male Middle Aged Mitral Valve / surgery* Mitral Valve Insufficiency / diagnosis, surgery* Myocardial Ischemia / complications, diagnosis, surgery* Pericardium / transplantation* Postoperative Complications / diagnosis Stroke Volume / physiology Suture Techniques Ventricular Dysfunction, Left / diagnosis, surgery |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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