Changes of left ventricular remodeling after artificial chordae implantation and its effect on the recurrence of mitral regurgitation
10.3760/cma.j.cn112434-20220909-00293
- VernacularTitle:人工腱索植入术后左心室重构变化情况及对二尖瓣反流复发的影响
- Author:
Zhaolei JIANG
1
;
Ju MEI
;
Jianbing HUANG
;
Fangbao DING
;
Min TANG
;
Hao LIU
;
Jie CAI
;
Sai’e SHEN
Author Information
1. 上海交通大学医学院附属新华医院心胸外科，上海 200092
- Keywords:
Artificial chordae;
Mitral valvuloplasty;
Mitral regurgitation;
Left ventricular reverse remodeling
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2023;39(8):449-453
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the changes of left ventricular remodeling after artificial chordae implantation and its effect on the recurrence of mitral regurgitation(MR).Methods:Clinical data of 141 patients with severe mitral regurgitation(Carpentier type Ⅱ) repaired by artificial chordae technique in our hospital from January 2010 to December 2019 were retrospectively analyzed. Patients were divided into significant regurgitation group(15 cases) and non- significant regurgitation group(126 cases) according to the presence or absence of moderate regurgitation by follow-up echocardiography. To observe the effect of left ventricular reverse remodeling(LVRR) on the recurrence of MR after artificial chordae implantation and analyze the risk factors.Results:All patients successfully underwent mitral valvuloplasty with artificial chordae. In the early postoperative period(30 days after operation), LVRR appeared in both groups(LVEDD and LVESD were significantly smaller than those before operation, P<0.05); LVRR was further enhanced(LVEDD and LVESD were further reduced, P<0.05) in non- significant regurgitation group at 1 year after operation, but left ventricular remodeling reoccurred in significant regurgitation group at 1 year after operation(LVEDD and LVESD increased compared with the early postoperative period, P<0.05). After 12-132 months’ follow-up, 15 patients had more than moderate MR. In the early postoperative period, 13 patients had more than mild MR, 8 of which evolved to more than moderate MR during follow-up. Cox regression showed that LVEDD≥65 mm( HR=5.573) and more than mild MR in the early postoperative period( HR=8.801) were the risk factors for the recurrence of MR after artificial chordae implantation. Conclusion:LVRR appeared in the early postoperative period, and the degree of LVRR further increased at 1 year after operation, but the patients with significant MR would reappear left ventricular remodeling. Early postoperative LVRR had a bad effect on the recurrence of MR after artificial chordae implantation, while further enhanced LVRR at 1 year after operation had little effect on the recurrence MR.
