Simple and Effective Surgical Repair with Vascular Graft Strip for Ischemic MR.
- Author:
Ho Ki MIN
1
;
Seung Hoon LEE
;
Ju Hyeon LEE
;
Kiick SUNG
;
Kay Hyunc PARK
;
Tae Gook JUN
;
Pyo Won PARK
;
Young Tak LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea. ytlee@yahoo.com
- Publication Type:Original Article
- Keywords:
Mitral valve insufficiency;
Myocardial ischemia;
Mitral valve, repair
- MeSH:
Arrhythmias, Cardiac;
Cardiomyopathies;
Catheterization;
Constriction, Pathologic;
Heart Atria;
Humans;
Hypertension;
Mitral Valve;
Mitral Valve Insufficiency;
Mortality;
Myocardial Ischemia;
Papillary Muscles;
Renal Dialysis;
Renal Insufficiency;
Risk Factors;
Subclavian Artery;
Sutures;
Transplants*;
Tricuspid Valve
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2003;36(9):646-650
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Many surgical techniques for ischemic mitral regurgitation (IMR) have been used with their excellent results and advantages. Here, we report our simple posterior annuloplasty techniques using vascular graft strip with their early results. MATERIAL AND METHOD: Twenty two patients (13 male) underwent the operations for IMR (excluding the papillary muscle rupture) from December 2001 to January 2003. Preoperative risk factors were low ejection fraction (<35%, n=9), hypertension (n=13), diabetes (n=9), and renal failure (Cr>2.5, n=4). The wide dissection beneath the both vena cavae and interatrial groove after bicaval cannulation enabled the easy exposure of mitral valve even in the small left atrium. After eight or nine interrupted sutures in posterior annulus for anchoring the 6 mm width vascular graft strip, symmetric (n=8) or asymmetric (n=14) annuloplasty were done. Combined surgeries were CABG (n=21), Dor procedures (n=3), tricuspid valve annuloplasty (n=1), Maze operation (n=1), and aorto-right subclavian artery bypass (n=1). RESULT: Except for one surgical mortality, all the patients were doing well and the mean grade of regurgitation was decreased from 2.95 to 0.88, however the ejection fraction had not changed significantly just before discharge. Post-operative valve function evaluated before discharge revealed no residual regurgitation in 8 (including 1 patient with mild stenosis due to over reduction), minimal in 11, mild in 2, and mild to moderate regurgitation in 1. One patient who had ischemic cardiomyopathy and renal failure died of the arrhythmia during the hemodialysis. CONCLUSION: These observations suggest that the annuloplasty with vascular graft strip could be a safe and cost effective techniques for ischemic mitral regurgitation. However, the long term evaluation for the mitral valve function should be defined for the final conclusion.
