Document Detail


"Bow-tie" mitral valve repair: an adjuvant technique for ischemic mitral regurgitation.
MedLine Citation:
PMID:  9875764     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
J P Umaña; B Salehizadeh; J J DeRose; T Nahar; A Lotvin; S Homma; M C Oz
Related Documents :
4050654 - Experience with outlet strut fracture of the björk-shiley convexoconcave mitral valve ...
8834734 - One leaflet immobilization after mitral valve replacement with a bileaflet prosthesis.
7917354 - Cleft in the anterior and posterior leaflet of the mitral valve: a rare anomaly.
18490344 - Aorta-atrial fistula, a rare complication of prosthetic valve endocarditis.
3056674 - Selective inhibition of thromboxane synthetase reduces group-b-beta-hemolytic-streptoco...
8736594 - Outflow tract abnormalities in atrioventricular canal malformations.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  66     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1999-02-03     Completed Date:  1999-02-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1640-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiothoracic Surgery, Columbia University College of Physicians & Surgeons, New York, New York, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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


Previous Document:  Coronary artery bypass grafting in patients with advanced left ventricular dysfunction.
Next Document:  Lazaroid U74500A is superior to U74006F in preserving rabbit heart for 24 hours.