Tei index to assess perioperative left ventricular systolic function in patients undergoing mitral valve repair

Abstract Background Valve repair is the treatment of choice for native mitral valve regurgitation. The feasibility of repair when the defect is caused by acute infective endocarditis (IE) is debated. This study aims to compare the outcome of repair and replacement procedures, to report the rate of repair in a single surgical center, and to review the literature on this topic. Results We retrospectively analyzed 108 patients with native mitral IE, potentially eligible for surgical repair. Of these 108, 90 (83%) underwent surgery, and 18 were treated conservatively. Among the 90 surgical patients, 57 (63%) underwent valve replacement and 33 valve repair (37%). The mean follow-up duration was 3 years. The two primary endpoints were mortality and freedom from recurrent endocarditis. Secondary endpoints were the post-operative incidence of major adverse events (hospitalization for any cause, pacemaker implantation, new onset of atrial fibrillation, sternal dehiscence), left ventricular systolic function (LVSF), and valvular function at 1-year echocardiographic follow-up. All-cause mortality was lower for valve repair, although not significantly (p = 0.86), as well as nonfatal adverse events (p = 0.92) and relapse rate (p = 0.20) at 3 years. We did not find differences between the two groups at echocardiographic follow-up, neither for left ventricular systolic function (p = 0.22), nor for valvular continence (p = 0.28). Conclusions In our experience, the mid-term outcome of repair in IE is comparable to valve replacement and should be considered whenever possible, as in degenerative valve disease. The review of the literature supports this strategy.

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Mitral valve repair for degenerative mitral regurgitation in patients with left ventricular systolic dysfunction: early and mid-term outcomes

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-01309-6 ◽

2020 ◽

Vol 15 (1) ◽

Cited By ~ 1

Author(s):

Jun Li ◽

Yun Zhao ◽

Tianyu Zhou ◽

Yongshi Wang ◽

Kai Zhu ◽

...

Keyword(s):

Mitral Valve ◽

Left Ventricular Systolic Dysfunction ◽

Systolic Function ◽

Systolic Dysfunction ◽

Left Ventricular Systolic Function ◽

Left Ventricular ◽

Ventricular Systolic Dysfunction ◽

Valve Repair ◽

Ventricular Systolic Function

Abstract Background This study aims to evaluate the early and mid-term outcomes of mitral valve repair for degenerative mitral regurgitation (MR) in patients with left ventricular systolic dysfunction. Methods From January 2005 to December 2016, the profiles of patients with degenerative MR who underwent mitral valve repair at our institution were analyzed. Left ventricular systolic dysfunction was defined as an ejection fraction < 60% or left ventricular end-systolic dimension > 40 mm. Finally, 322 patients with left ventricular systolic dysfunction were included in this study. The prognosis of left ventricular function during follow-up was evaluated and preoperative factors associated with deteriorated left ventricular systolic function during follow-up were analyzed. Results The in-hospital mortality rate was 1.6%. The rate of eight-year overall survival, freedom from reoperation for mitral valve and freedom from recurrent MR were 96.9, 91.2 and 73.4%, respectively. Intraoperative residual mild MR (hazard ratio 4.82) and an isolated anterior leaflet lesion (hazard ratio 2.48) were independent predictive factors for recurrent MR. During follow-up, 212 patients underwent echocardiography examinations at our institution. Among them, 132 patients had improved left ventricular systolic function, and 80 patients had deteriorated left ventricular systolic. Freedom from recurrent MR was found in 75.9% of the improved left ventricular systolic function group and 56.2% of the deteriorated left ventricular systolic function group (P = 0.047). An age > 50 years (odds ratio 2.40), ejection fraction≤52% (odds ratio 2.79) and left ventricular end-systolic dimension≥45 mm (odds ratio 2.31) were independent risk factors for deteriorated left ventricular systolic function during follow-up. Conclusions Mitral valve repair could be safely performed for degenerative MR in patients with left ventricular systolic dysfunction. Intraoperative residual mild MR and an isolated anterior leaflet lesion were independent predictive factors for recurrent MR. An age > 50 years, ejection fraction≤52% and left ventricular end-systolic dimension≥45 mm were independent risk factors for deteriorated left ventricular systolic function during follow-up.

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Tissue Motion Annular Displacement of the Mitral Valve Can Be a Useful Index for the Evaluation of Left Ventricular Systolic Function by Echocardiography in Normal Children

Pediatric Cardiology ◽

10.1007/s00246-018-1847-2 ◽

2018 ◽

Vol 39 (5) ◽

pp. 976-982 ◽

Cited By ~ 3

Author(s):

Dai Asada ◽

Kenichi Okumura ◽

Kazuyuki Ikeda ◽

Toshiyuki Itoi

Keyword(s):

Mitral Valve ◽

Systolic Function ◽

Left Ventricular Systolic Function ◽

Left Ventricular ◽

Ventricular Systolic Function ◽

Normal Children ◽

Tissue Motion

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Mapping catheter-related mitral valve injury: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa311 ◽

2020 ◽

Vol 4 (5) ◽

pp. 1-6

Author(s):

Simran Shergill ◽

Nigel R A Clarke

Keyword(s):

Mitral Valve ◽

Systolic Function ◽

Left Ventricular Systolic Function ◽

Left Ventricular ◽

Valve Repair ◽

Ablation Procedure ◽

Case Summary ◽

Prompt Diagnosis ◽

Mapping Catheter

Abstract Background An increasing number of catheter ablations are performed for symptomatic tachyarrhythmias and commonly involve the left atrium, increasing the risk of catheter interaction with the mitral valve (MV) complex. Mitral valve trauma at the time of atrial fibrillation (AF) ablations remains a rare yet emergent situation that requires prompt diagnosis and management to prevent the long-term sequelae of heart failure secondary to MV dysfunction. Case summary We present a case of a 69-year-old female with symptomatic paroxysmal AF and atrial flutter who underwent a combined ablation procedure. During the pulmonary vein isolation procedure, the mapping catheter became entangled within the MV apparatus but was freed. She presented to our hospital 2 weeks later with dyspnoea, lethargy, and a cough. Clinical examination revealed a pansystolic murmur and right moderate pleural effusion. Transthoracic echocardiogram (TTE) demonstrated a flail posterior MV leaflet with severe eccentric mitral regurgitation (MR). She underwent urgent valve repair at the regional cardiothoracic centre. Upon review 2 months later, she was symptom free with surveillance TTE demonstrating a preserved left ventricular systolic function with a trace of MR. Discussion Mitral valve injury secondary to catheter entrapment at the time of left-sided ablations is a rare yet serious complication and can present as an emergent situation requiring prompt recognition and early surgical management to salvage valve and cardiac function.

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STUDY OF LEFT VENTRICULAR SYSTOLIC FUNCTION ON TISSUE DOPPLER

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.5.20 ◽

2017 ◽

pp. 146-149

Author(s):

Thi Bich Phuong Nguyen ◽

Anh Vu Nguyen

Keyword(s):

Mitral Valve ◽

Tissue Doppler Imaging ◽

Systolic Function ◽

Left Ventricular Systolic Function ◽

Tissue Doppler ◽

Left Ventricular ◽

Doppler Imaging ◽

Left Ventricular Ejection ◽

Ventricular Systolic Function ◽

Ventricular Performance

Background: There are many new methods for evaluating the left ventricular systolic function. The aim of this study was to compare the methods, which evaluate the systolic function such as M-modeTeichholz method, tissue Doppler imaging with Sm wave. Methods: 65 patients hospitalized with hypertension and dilated cardiomyopathy. All patients underwent echocardiographic examination by M-mode, two- dimensional, Doppler and tissue Doppler Imaging. Results:When left ventricular ejection fraction (EF) reduced, TDI with Sm velocity were also lower (p<0.001). When lateral Sm of mitral valve ring were > 7.7 cm/s and septal Sm mitral valve ring were > 6cm/s, EF ≥ 50% with the sensitivity 96,2% and the specificity 89.7%. Conclusions: Sm wave velocity may be used reliably to assess the left ventricular performance regardless of the patient’s echogenity. Key words: Tisue Doppler, Systolic left ventricular function

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