Pseudoprolapse of the anterior leaflet in chronic ischemic mitral regurgitation: identification and repair.
Name:
Publisher version
View Source
Access full-text PDFOpen Access
View Source
Check access options
Check access options
Average rating
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Star rating
Your vote was cast
Thank you for your feedback
Thank you for your feedback
Authors
Hashim, Sabet WYoussef, Samuel J
Ayyash, Bassem
Rousou, Anthony J
Ragnarsson, Sigurdur
Collazo, Susan
Geirsson, Arnar
Issue Date
2012-04
Metadata
Show full item recordCitation
J. Thorac. Cardiovasc. Surg. 2012, 143(4 Suppl):S33-7Abstract
Recurrence rates as high as 30% have been observed 6 months after treatment of chronic ischemic mitral regurgitation (CIMR) with isolated annuloplasty. We postulated that the high early recurrence rates resulted from the presence of untreated pseudoprolapse of the anterior leaflet. We conducted a retrospective study of all mitral valve repairs for CIMR performed by a single surgeon (S.W.H.) from 1995 to 2011. After annuloplasty, Gore-Tex neochordae were added if the high-pressure saline test indicated the presence of pseudoprolapse of the anterior leaflet. A total of 47 patients underwent mitral valve repair for CIMR. Of the 47 patients, 24 (51%) were found to have pseudoprolapse requiring the addition of neochordae. For all patients, the average age was 65.1 years, and 65.2% were men. Fourteen (30%) had had a preoperative intra-aortic balloon pump placed by cardiologists. Fourteen (30%) had severe pulmonary hypertension. Concomitant coronary artery bypass grafting was performed in 40 patients, with an average of 2.2 grafts; 7 had previously undergone coronary artery bypass grafting. Mitral Carpentier-Edwards physio annuloplasty rings were used in all patients with a mean size of 29 mm. One patient died postoperatively. Follow-up data were available for all 47 patients at an average of 4.9 years. The 5-year survival rate was 82.5%. The mean pre- and postoperative New York Heart Association class, ejection fraction, and mitral regurgitation grade were 3 and 1.52 (P < .0001), 34% and 41% (P = .0006), and 3.51 and 1.08 (P < .0001), respectively. Two patients developed greater than moderate mitral regurgitation. Effective repair of CIMR should include surgical techniques to correct pseudoprolapse of the anterior leaflet, when present. The selective addition of Gore-Tex neochordae to an undersized annuloplasty nearly eliminates recurrent regurgitation after mitral valve repair for CIMR.Description
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field.Additional Links
http://dx.doi.org/10.1016/j.jtcvs.2011.09.063http://www.sciencedirect.com/science/article/pii/S0022522311010828
Rights
Archived with thanks to The Journal of thoracic and cardiovascular surgeryae974a485f413a2113503eed53cd6c53
10.1016/j.jtcvs.2011.09.063
Scopus Count
Collections
Related articles
- Three-dimensional valve repair-the better care? Midterm results of a saddle-shaped, rigid annuloplasty ring in patients with ischemic mitral regurgitation.
- Authors: Guenzinger R, Schneider EP, Guenther T, Wolf P, Mazzitelli D, Lange R, Voss B
- Issue date: 2014 Jul
- Polytetrafluoroethylene neochordae is noninferior to leaflet resection in repair of isolated posterior mitral leaflet prolapse: a multicentre study.
- Authors: Ragnarsson S, Sjögren J, Sanchez R, Wierup P, Nozohoor S
- Issue date: 2014 Oct
- Outcomes of coronary artery bypass grafting and reduction annuloplasty for functional ischemic mitral regurgitation: a prospective multicenter study (Randomized Evaluation of a Surgical Treatment for Off-Pump Repair of the Mitral Valve).
- Authors: Grossi EA, Woo YJ, Patel N, Goldberg JD, Schwartz CF, Subramanian VA, Genco C, Goldman SM, Zenati MA, Wolfe JA, Mishra YK, Trehan N
- Issue date: 2011 Jan
- Very long-term durability of the edge-to-edge repair for isolated anterior mitral leaflet prolapse: up to 21 years of clinical and echocardiographic results.
- Authors: De Bonis M, Lapenna E, Taramasso M, La Canna G, Buzzatti N, Pappalardo F, Alfieri O
- Issue date: 2014 Nov
- Clinical and echocardiographic outcomes after repair of mitral valve bileaflet prolapse due to myxomatous disease.
- Authors: Chan V, Ruel M, Chaudry S, Lambert S, Mesana TG
- Issue date: 2012 Apr