Clinical Characteristics of Surgically Corrected Mitral Regurgitation Due to Myxomatous Degeneration in Korea.
10.4070/kcj.2001.31.10.1042
- Author:
Soo Jin KANG
1
;
Jae Kwan SONG
;
Hyun Sook KIM
;
Jong Min SONG
;
Duk Hyun KANG
;
Cheol Whan LEE
;
Myeong Ki HONG
;
Jae Joong KIM
;
Seong Wook PARK
;
Seung Jung PARK
;
Jae Won LEE
;
Suk Jung CHOO
;
Hyun SONG
;
Meong Gun SONG
Author Information
1. Division of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Myxomatous degeneration;
Mitral valve prolapse;
Chordae rupture;
Mitral regurgitation
- MeSH:
Age Distribution;
Disease-Free Survival;
Female;
Humans;
Hypertension;
Incidence;
Korea*;
Male;
Mitral Valve;
Mitral Valve Insufficiency*;
Mitral Valve Prolapse;
Prevalence;
Prognosis;
Prolapse;
Retrospective Studies;
Rupture
- From:Korean Circulation Journal
2001;31(10):1042-1048
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Although the clinical significance of mitral regurgitation (MR) due to prolapse or chordae rupture with myxomatous degeneration (MD) is increasing significantly, clinical features of patients with MD in Korea are not characterized. MATERIALS AND METHODS: Retrospective analysis of clinical data of 90 patients who underwent surgical correction of significant MR due to MD was performed. Lesion sites of MD were confirmed during surgery; anterior (A) and posterior (P) mitral leaflets were divided into lateral (A1 & P1), middle (A2 & P2), and medial segments (A3 & P3). METHODS: Mean age was 5114 years and male / female ratio was 1; age distribution showed typical bimodal pattern with two peaks at the mid-thirties and the mid-fifties each. MD was confined to P leaflet in 36 (40%), A leaflet in 20 (22%), and both leaflets in 34 patients (38%). Forty-six patients (51%) showed MD in a single segment, and 37 (41%) in 2 segments; 7 patients (8%) showed MD in more than 2 segments. In 90 patients, pathologic MD was confirmed in 139 mitral segments; among them, P3 was the most commonly involved segment (30%), followed by A3 (17%), P2 (14%), A2 (14%), A1 (14%), and P1 (12%). Hypertension (HT) was more frequently observed in female patients (42%) than in male patients (16%) (p<0.05). Chordae rupture was observed in 71 patients (79%), which was associated with HT. Younger patients (age<45 years, N=31) showed lower prevalence of HT and higher incidence of MD involving multiple segments. Valve repair was successful in 83 patients (92%), which was not associated with lesion sites or numbers of MD. Three-year event free survival rate was 865% and independent on sites and numbers of MD. CONCLUSION: MD develops preferentially in the medial part of the mitral valve, and patterns of clinical presentation can change according to the age and existence of HT in these selected patients with significant MR. However, the morphologic characteristics of MD do not seem to affect the feasibility of repair and long-term prognosis.
