Long-Term Echocardiographic Follow-up after Posterior Mitral Annuloplasty Using a Vascular Strip for Ischemic Mitral Regurgitation: Ten-Years of Experience at a Single Center.
10.3346/jkms.2011.26.12.1582
- Author:
Dong Seop JEONG
1
;
Hae Young LEE
;
Wook Sung KIM
;
Kiick SUNG
;
Tae Gook JUN
;
Ji Hyuk YANG
;
Pyo Won PARK
;
Young Tak LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ytlee55@yahoo.com
- Publication Type:Original Article
- Keywords:
Coronary Artery Disease;
Myocardial Ischemia;
Mitral Valve Iinsufficiency;
Myocardial Revascularization;
Mitral Valve Annuloplasty
- MeSH:
Aged;
Aged, 80 and over;
Coronary Artery Disease/mortality/*surgery;
Echocardiography;
Female;
Follow-Up Studies;
Heart Valve Prosthesis Implantation;
Humans;
Male;
Middle Aged;
Mitral Valve/physiopathology/*surgery;
Mitral Valve Annuloplasty/*methods;
Mitral Valve Insufficiency/mortality/*surgery;
Myocardial Ischemia/mortality/*surgery;
Myocardial Revascularization;
Stroke Volume;
Treatment Outcome;
Vascular Surgical Procedures
- From:Journal of Korean Medical Science
2011;26(12):1582-1590
- CountryRepublic of Korea
- Language:English
-
Abstract:
Management of ischemic mitral regurgitation (MR) is challenging. The aim of this study was to investigate long-term clinical and echocardiographic results of restrictive mitral annuloplasty for ischemic MR. From 2001 through 2010, 96 patients who underwent myocardial revascularization with restrictive mitral annuloplasty using a vascular strip for ischemic MR were analyzed. Patients were stratified into two groups based on left ventricular ejection fraction (LVEF): group I, n = 50, with LVEF > 35% and group II, n = 46, with LVEF < or = 35%. The early mortality rate was 2.1% (2/96) and the late cardiac mortality rate was 11.5% (11/96). MR grade was reduced at discharge (0.8 +/- 0.7) but increased during follow-up (1.1 +/- 0.8, P = 0.001). There was no intergroup difference in terms of freedom from recurrent MR > or = moderate eight years after surgery (94.1% +/- 5.7%, group I vs 87.8% +/- 7.2%, group II; P = 0.575). NYHA functional class (odds ratio [OR], 2.2; P = 0.044) and early postoperative residual MR > or = mild (OR, 25.4; P < 0.001) were independent predictors of recurrent MR. Restrictive mitral annuloplasty using a vascular strip is effective in ischemic MR. It is important to avoid early postoperative residual MR.
