scholarly journals “RFEF” and mitral regurgitation jet direction: surrogate markers for likelihood of left ventricle reverse remodeling in patients with moderate chronic ischemic mitral regurgitation

2018 ◽  
Vol 35 (2) ◽  
pp. 158-167 ◽  
Author(s):  
Sumbul Siddiqui ◽  
Amber Malhotra ◽  
Komal Shah ◽  
Pankaj Garg ◽  
Pranav Sharma ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Ischemic Mitral Regurgitation ◽  
Reverse Remodeling ◽  
Surrogate Markers ◽  
Chronic Ischemic Mitral Regurgitation

scholarly journals The value of adding sub-valvular procedures for chronic ischemic mitral regurgitation surgery: a meta-analysis

Perfusion ◽  
2017 ◽  
Vol 32 (6) ◽  
pp. 436-445 ◽  
Author(s):  
Marco Moscarelli ◽  
Thanos Athanasiou ◽  
Giuseppe Speziale ◽  
Prakash P. Punjabi ◽  
George Malietzis ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Meta Analysis ◽  
Late Recurrence ◽  
Early Mortality ◽  
Ischemic Mitral Regurgitation ◽  
Term Survival ◽  
Left Ventricle Remodeling ◽  
Late Failure ◽  
Chronic Ischemic Mitral Regurgitation

Background: The most performed repair technique for the treatment of chronic ischemic mitral regurgitation in patients referred for bypass grafting remains restricted annuloplasty. However, it is associated with a high rate of failure, especially if severe tenting exists. Objectives: To understand if adjunctive sub-valvular mitral procedures may provide better repair performance. Methods: A systematic literature review identified six studies of which five fulfilled the criteria for meta-analysis. Outcomes for a total of 404 patients (214 had adjunctive sub-valvular procedures and 190 restricted annuloplasty) were meta-analyzed using random effects modeling. Heterogeneity and subgroup sensitivity analysis were assessed. Primary endpoints were: late recurrence of moderate mitral regurgitation, left ventricle remodeling and coaptation depth at follow-up. Secondary endpoints were: early mortality, mid-term survival and operative outcomes. Results: Sub-valvular procedure technique was associated with a significantly lower late recurrence of mitral regurgitation (Odds ratio (OR) 0.34, 95% Confidence Interval (CI) [0.18, 0.65], p=0.0009), smaller left ventricle end-systolic diameter (Weighted Mean Difference (WMD) -4.06, 95% CI [-6.10, -2.03], p=0.0001) and reduced coaptation depth (WMD -2.36, 95% CI [-5.01, -0.71], p=0.009). These findings were consistent, even in studies that included patients at high risk for repair failure (coaptation depth >10 mm and tenting area >2.5 cm2). A low degree of heterogeneity was observed. There was no difference in terms of early mortality and mid-term survival; sub-valvular technique was associated with prolonged cardiopulmonary and cross-clamp time. Conclusions: Adding sub-valvular procedures when repairing ischemic chronic mitral valve regurgitation may be associated with better durability, even in the case of the presence of predictors for late failure. Perspective: Surgical sub-valvular adjunctive procedures have to be considered in the case of the presence of echocardiographic predictors for late failure.

Outcomes of Mitral Valve Repair for Chronic Ischemic Mitral Regurgitation

2009 ◽  
Vol 17 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Lokeswara R Sajja ◽  
Gopichand Mannam ◽  
Bhaskara R S Dandu ◽  
Satyendranath Pathuri ◽  
Sriramulu Sompalli ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Ischemic Mitral Regurgitation ◽  
Valve Repair ◽  
Chronic Ischemic Mitral Regurgitation

Mitral tetrahedron as a geometrical surrogate for chronic ischemic mitral regurgitation

2005 ◽  
Vol 289 (3) ◽  
pp. H1218-H1225 ◽  
Author(s):  
Hsi-Yu Yu ◽  
Mao-Yuan Su ◽  
Yih-Sharng Chen ◽  
Fang-Yue Lin ◽  
Wen-Yih Isaac Tseng
Keyword(s):  
Mitral Regurgitation ◽  
Surface Area ◽  
Left Ventricular ◽  
Ischemic Mitral Regurgitation ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Area Index ◽  
Ventricular Ejection Fraction ◽  
Cutoff Values ◽  
Chronic Ischemic Mitral Regurgitation

The present study tests the hypothesis that a mitral tetrahedron (MT) is a useful geometrical surrogate for assessment of chronic ischemic mitral regurgitation (CIMR). Fifty-eight subjects were divided into three groups on the basis of left ventricular ejection fraction (LVEF) and the presence or absence of CIMR: LVEF ≥0.5 and negative CIMR ( group 1, n = 28), LVEF <0.5 and negative CIMR ( group 2, n = 12), and LVEF <0.5 and positive CIMR ( group 3, n = 18). MT was defined by its four vertices at the anterior annulus, posterior annulus, and medial and lateral papillary muscle roots, determined by MRI at peak systole. The results showed no clear cutoff values of MT parameters between groups 2 and 1. In contrast, all MT indexes were significantly different between groups 3 and 2 ( P < 0.05), and significant cutoff values differentiated the two groups. A scoring system employing parameters of the whole MT confirmed the absence of CIMR with total edge length index <268 mm/BSA1/3, total surface area index <2,528 mm2/BSA2/3, and volume index <5,089 mm3/BSA (where BSA is body surface area). The sensitivity, specificity, and positive and negative predictive values were 1.00. This preliminary study demonstrates that MT might serve as a good geometrical surrogate for assessing CIMR. The derived geometrical criteria of MT may be useful in surgical correction of CIMR.

Surgery for chronic ischemic mitral regurgitation – which mitral intervention?

2011 ◽  
Vol 9 (5) ◽  
pp. 587-597 ◽  
Author(s):  
Michael O Murphy ◽  
Kamran Ahmed ◽  
Thanos Athanasiou
Keyword(s):  
Mitral Regurgitation ◽  
Ischemic Mitral Regurgitation ◽  
Chronic Ischemic Mitral Regurgitation
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