Early diastolic mitral regurgitation in left ventricular aneurysm

Aim: To evaluate the effects of combined coronary artery bypass grafting (CABG), surgical left ventricular restoration (LVR), and mitral valve repair (MVP) in treating ischemic heart disease combined with mitral regurgitation; and to evaluate the different strategies of LVR and MVP.Methods: From January 2001 to December 2015, 61 consecutive patients with left ventricular aneurysm and ischemic mitral regurgitation underwent concomitant CABG, LVR and MVP. We evaluated the clinical and echocardiographic outcomes of the patients. The mean follow-up was 5.8 ± 3.3 years.Results: The operative mortality was 4.9%. One-, five-, and ten-year survival rates were 95.1%, 86.9%, and 80.3%, respectively. Mitral regurgitation, left ventricular ejection fraction (LVEF), and left ventricular end diastolic diameter (LVEDD) improved significantly after surgery (P < .001). During follow-up, 3 patients (5.2%) had moderate mitral regurgitation and 1 patient (1.9%) had severe mitral regurgitation. The clinical outcomes were not influenced by the LVR technique and MVP approach.Conclusion: Combined CABG, LVR, and MVP was effective for ischemic left ventricular aneurysm with mitral regurgitation. The procedure was associated with acceptable operative risk and clinical outcomes.

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Femoral Bypass with Left Thoracotomy for Submitral Left Ventricular Aneurysm

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849239800600114 ◽

1998 ◽

Vol 6 (1) ◽

pp. 57-59 ◽

Cited By ~ 1

Author(s):

Soman Rema Krishna Manohar ◽

Ramesh Chandra Rathod ◽

Jagan Mohan Tharakan

Keyword(s):

Mitral Regurgitation ◽

Left Ventricular ◽

Left Ventricular Aneurysm ◽

Ventricular Aneurysm ◽

Left Thoracotomy ◽

Femorofemoral Bypass

A simplified technique for repair of submitral left ventricular aneurysm is presented. Since the patient had no mitral regurgitation the aneurysm was approached through a left thoracotomy with femorofemoral bypass and the repair was technically simple.

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A successful treatment of ischemic cardiomyopathy associated with left ventricular aneurysm and chronic ischaemic mitral regurgitation (RCD code: III-1B.9.o).

Journal of Rare Cardiovascular Diseases ◽

10.20418/jrcd.vol3no4.271 ◽

2017 ◽

Vol 3 (4) ◽

pp. 122 ◽

Cited By ~ 1

Author(s):

Klaudia Knap ◽

Leszek Drabik ◽

Justyna Błaut-Jurkowska ◽

Michał Pacia ◽

Maciej Krupiński ◽

...

Keyword(s):

Mitral Regurgitation ◽

Successful Treatment ◽

Ischemic Cardiomyopathy ◽

Left Ventricular ◽

Left Ventricular Aneurysm ◽

Ventricular Aneurysm

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Surgical Treatment of Left Ventricular Aneurysm Combined with Ischemic Mitral Regurgitation Using a Modified Technique

Ukrainian journal of cardiovascular surgery ◽

10.30702/ujcvs/21.4409/r.r.037-38-42 ◽

2021 ◽

pp. 38-42

Author(s):

Sergiy A. Rudenko ◽

Anatoliy V. Rudenko ◽

Sergey A. Sokur ◽

Oleh V. Zhyliak ◽

Larysa A. Klimenko

Keyword(s):

Heart Failure ◽

Surgical Treatment ◽

Mitral Regurgitation ◽

Cardiac Arrhythmias ◽

Left Ventricular ◽

Ischemic Mitral Regurgitation ◽

Left Ventricular Aneurysm ◽

Ventricular Aneurysm ◽

Modified Technique ◽

Lv Aneurysm

Background. Ischemic mitral regurgitation (IMR) is the second most common cause of mitral regurgitation (MR). IMR occurs in patients with myocardial infarction due to a rupture of the subvalvular apparatus. Pathological remodel-ing, dilatation and dysfunction of the left ventricle (LV) play a significant role in the development of IMR. The presence of a postinfarction LV aneurysm can lead to the development of MR due to dysfunction, relative and true shortening of the papillary muscles. There are various methods of surgical correction of IMR. The aim. To show the effectiveness of surgical treatment of left ventricular aneurysm combined with ischemic mitral regurgitation using a modified technique. Materials and methods. From January 2011 to December 2019, 20 patients with IMR combined with LV aneurysm underwent surgical intervention using a modified technique at the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine. According to this technique, access to the mitral valve was performed through the left ventricle. The mean age of the patients was 61.2 ± 10.1 years. Among patients with IMR, the majority were men (60.0%). The overwhelming majority of patients (80.0%) had the history of hypertension. Diabetes mellitus was detected in 35.0% of patients. Mitral ring dilatation was observed in 25.0% (5) of the cases, papillary muscle displacement in 40.0% (8), chords rupture in 15.0% (3), papillary muscle infarction in 20.0% (4) of the cases. All the patients had reduced LV ejection fraction with a mean value of 34.5 ± 7.8%. Results. Aortic cross-clamp time through ventricular access was 112.9 ± 18.7 minutes. The duration of mechanical ventilation was 19.1 ± 20.6 hours. The length of stay of patients in the ICU was 99.2 ± 43.5 hours. There were no signs of acute heart failure in the early postoperative period in one in five patients (20.0%). The rate of degree III heart failure after intervention using the modified technique was 20.0% (4). The study of the incidence of cardiac arrhythmias after combined intervention showed that 85.0% (17) of patients operated using the modified technique had no cardiac arrhythmias. Conclusions. In patients who underwent surgery using the modified technique, the mortality rate was 5.0%. This is 1.6-2.8 times less than that in patients undergoing conventional operation. Postoperative occurrence of arrhythmias is much less common than that described in the literature.

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