| "Bow-tie" mitral valve repair: an adjuvant technique for ischemic mitral regurgitation. | |
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MedLine Citation:
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PMID: 9875764 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Current techniques of mitral valve repair rely on decreasing valve area to increase leaflet apposition, but fail to address subvalvular dysfunction. A novel repair has been introduced with partial left ventriculectomy, which apposes the anterior leaflet to a corresponding point on the posterior leaflet creating a double-orifice valve, with reported adequate control of mitral regurgitation. METHODS: We started to use the "bow-tie" repair as an adjunct to posterior ring annuloplasty in cases in which mitral regurgitation was not adequately controlled by decreasing mitral valve area (n = 6), or when placement of an annuloplasty ring was impractical (n = 4). Mean follow-up was 336 days (range, 82 to 551 days) with no postoperative deaths. RESULTS: Mitral regurgitation decreased from 3.6+/-0.5 to 0.8+/-0.4 (p < 0.0001), with a concomitant increase in ejection fraction from 33%+/-13% to 45%+/-11% (p = 0.0156) before hospital discharge. Mitral valve area, measured by pressure half-time, decreased from a mean of 2.5+/-0.3 to 2.1+/-0.3 cm2, with a mean transvalvular gradient of 4.5+/-2.0 mm Hg. In patients whose mitral valve was repaired using the bow-tie alone, mitral regurgitation was reduced from 4+, to a trace to 1+. Postoperatively, mitral valve area increased from 1.9 to 2.5 cm2 during exercise, further supporting the concept that this technique preserves mitral valve annular function. CONCLUSIONS: These observations suggest that the bow-tie repair may offer advantages over conventional techniques of mitral valve repair and should be considered as an adjunct, especially in patients with impaired left ventricular function. |
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Authors:
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J P Umaña; B Salehizadeh; J J DeRose; T Nahar; A Lotvin; S Homma; M C Oz |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 66 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 1998 Nov |
Date Detail:
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Created Date: 1999-02-03 Completed Date: 1999-02-03 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1640-6 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiothoracic Surgery, Columbia University College of Physicians & Surgeons, New York, New York, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angina Pectoris / complications Female Heart Ventricles / surgery Humans Male Methods Middle Aged Mitral Valve / surgery* Mitral Valve Insufficiency / surgery* Stroke Volume Ventricular Dysfunction, Left / complications |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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