scholarly journals Transcatheter mitral valve repair in proportionate and disproportionate functional mitral regurgitation—insights from a small cohort study

2021 ◽  
Author(s):  
J. F. Ooms ◽  
M. L. Geleijnse ◽  
E. Spitzer ◽  
B. Ren ◽  
M. P. Van Wiechen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Valve Repair ◽  
Data Set

Abstract Background Functional mitral regurgitation (FMR) can be subclassified based on its proportionality relative to left ventricular function and end-diastolic volume. FMR proportionality could help identify responders to transcatheter edge-to-edge mitral valve repair (MitraClip) in terms of residual FMR and/or clinical improvement. Methods This single-centre retrospective cohort study evaluated the feasibility of determining FMR proportionality in symptomatic heart failure patients with reduced left ventricular function who were treated with MitraClip for ≥ moderate-to-severe FMR. Baseline proportionate (pFMR) and disproportionate FMR (dFMR) were distinguished. Patient characteristics and MitraClip procedural outcomes were described. Results From an overall cohort of 81 eligible FMR patients, 23/81 (28%) had to be excluded due to missing transthoracic echocardiogram parameters, 22/81 were excluded based on FMR severity. The remaining cohort, of 36/81 patients (44%), could be classified into dFMR (n = 26) or pFMR (n = 10). Conduction disorders were numerically increased in dFMR. All cases requiring > 2 clips were in the dFMR group and absence of FMR reduction occurred more frequently with dFMR. Point of view/Conclusion Important limitations in terms of imaging acquisition affect the translation of the FMR proportionality concept to a real-world data set. We did observe different demographic and FMR response patterns in patients with proportionate and disproportionate FMR that warrant further investigation.

Surgery for Degenerative Mitral Regurgitation Valve Repair v. Valve Replacement with Chordal Preservation

1994 ◽  
Vol 2 (2) ◽  
pp. 90-94
Author(s):  
Masaharu Shigenobu ◽  
Shunji Sano
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Valve Repair ◽  
Repair Group

This study compares mitral valve repair and mitral valve replacement with chordal preservation for chronic mitral regurgitation due to myxomatous degeneration with special reference to left ventricular function. Twenty-six patients underwent complete preoperative and 2 years later postoperative echocardiography study. Thirteen patients underwent mitral valve replacement associated with preservation of chordae tendineae and papillary muscles, and 13 patients had mitral valve repair. There were no statistically significant differences between the 2 groups for clinical findings, hemodynamic profiles, or left ventricular function compared prior to surgery. After correcting mitral regurgitation, increase in cardiac index was significant for the repair group. Left ventricular end-diastolic volume decreased in both groups. Left ventricular end-systolic volume significantly decreased in the repair group, but remained unchanged in the replacement group. Both ejection fraction and mean left ventricular circumferential fiber shortening velocity (mVcf) decreased in the replacement group, but significantly increased in the repair group 2 years after surgery. These findings suggest valve replacement with chordal preservation shows less improvement in ventricular systolic function late after surgery compared with mitral valve repair.

Mitral valve repair: Conventional open techniques

2018 ◽  
pp. 135-144
Author(s):  
A. Marc Gillinov ◽  
Tomislav Mihaljevic
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Valve Repair ◽  
Younger Patients ◽  
Mechanical Prostheses ◽  
Surgical Option

Mitral valve repair is the preferred surgical option for nearly all patients with mitral regurgitation (MR) as its durability is widely recognized to be excellent. Advantages of mitral valve repair over mitral valve replacement include better preservation of left ventricular function, greater freedom from endocarditis and anticoagulant-related hemorrhage, and, in some cases, improved survival. Mitral valve repair has particular advantages in younger patients, who require lifelong anticoagulation if they receive mechanical prostheses. Mitral valve repair can be achieved in more than 90% of patients who have MR caused by prolapse. The forthcoming account includes an overview of the various techniques used in current practice.

Ischemic mitral valve repair: Correlations between the mechanisms of mitral regurgitation and left ventricular function prior to and following surgery

2005 ◽  
Vol 39 (3) ◽  
pp. 182-188 ◽  
Author(s):  
Jolanta Vaskelyte ◽  
Egle Ereminiene ◽  
Rimantas Benetis ◽  
Remigijus Zaliunas ◽  
Edmundas Sirvinskas
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Valve Repair

Changes in Left Ventricular Function After Mitral Valve Repair for Severe Organic Mitral Regurgitation

2012 ◽  
Vol 93 (3) ◽  
pp. 754-760 ◽  
Author(s):  
Tomasz G. Witkowski ◽  
James D. Thomas ◽  
Victoria Delgado ◽  
Eva van Rijnsoever ◽  
Arnold C.T. Ng ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Valve Repair

scholarly journals Ventricular arrhythmias in patients with functional mitral regurgitation and implantable cardiac devices: implications of mitral valve repair with Mitraclip

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Benito Gonzalez ◽  
X Freixa ◽  
C Godino ◽  
M Taramasso ◽  
R Estevez-Loureiro ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Functional Mitral Regurgitation ◽  
Valve Repair ◽  
One Year ◽  
The Impact

Abstract Background Limited information has been reported regarding the impact of percutaneous mitral valve repair (PMVR) on ventricular arrhythmic (VA) burden. The aim of this study was to address the incidence of VA and appropriate antitachycardia implantable cardiac defibrillator (ICD) therapies before and after PMVR. Methods We retrospectively analyzed all consecutive patients with heart failure with reduce left ventricular ejection fraction, functional mitral regurgitation grade 3+ or 4+ and an active ICD or cardiac resynchronizer who underwent PMVR in any of the eleven recruiting centers. Only patients with complete available device VA monitoring from one-year before to one year after PMVR were included. Baseline clinical and echocardiographic characteristics were collected before PMVR and at 12-months follow-up. Results 93 patients (68.2±10.9 years old, male 88.2%) were enrolled. PMVR was successfully performed in all patients and device success at discharge was 91.4%. At 12-months follow-up, we observed a significant reduction in mitral regurgitation severity, NT-proBNP and prevalence of severe pulmonary hypertension and severe kidney disease. Patients also referred a significant improvement in NYHA functional class and showed a non-significant trend to reserve left ventricular remodeling. After PMVR a significant decrease in the incidence of non-sustained ventricular tachycardia (VT) (5.0–17.8 vs 2.7–13.5, p=0.002), sustained VT or ventricular fibrillation (0.9–2.5 vs 0.5–2.9, p=0.012) and ICD antitachycardia therapies (2.5–12.0 vs 0.9–5.0, p=0.033) were observed. Conclusion PMVR was related to a reduction in arrhythmic burden and ICD therapies in our cohort. Proportion of patients who presented ven Funding Acknowledgement Type of funding source: None

scholarly journals Isolated Mitral Valve Repair in Patients with Reduced Left Ventricular Function

2019 ◽  
Author(s):  
M. Marin ◽  
T. Noack ◽  
F. Sieg ◽  
D. Holzhey ◽  
M. Misfeld ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Valve Repair
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