scholarly journals Impact of concomitant tricuspid annuloplasty on right ventricular remodeling in patients with rheumatic mitral valve disease

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yue Zhong ◽  
Wenjuan Bai ◽  
Hui Wang ◽  
Hong Qian ◽  
Li Rao
Keyword(s):  
Mitral Valve ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Mitral Valve Disease ◽  
Valve Disease ◽  
Maze Procedure ◽  
Tricuspid Annuloplasty ◽  
Concomitant Surgery ◽  
And Function

Abstract Background Studies on the management of functional tricuspid regurgitation (TR) during mitral valve operations have drawn inconsistent conclusions. This study was designed to compare the treatment strategy of concomitant tricuspid annuloplasty (TAP) against isolated mitral valve replacement (MVR) in rheumatic mitral valve disease patients, and to assess the effect of concomitant TAP on postoperative right ventricular (RV) remodeling and function. Methods One hundred-seventy patients with rheumatic mitral valve disease receiving MVR were categorized into TAP group (n = 124) and non-TAP group (n = 46). Clinical and echocardiographic data were collected preoperatively and at 1-year follow-up. Three-dimensional echocardiographic indices of RV geometry and function were analyzed. Results At baseline, concomitant TAP group had larger RV end-diastolic volume, more decreased RV ejection fraction and RV longitudinal strain than non-TAP group (all P <  0.001). At 1-year follow-up, TAP group had improved RV geometry and function. While adverse changes were observed in non-TAP group. In analysis of variance, the above indices demonstrated significant interaction with different treatment group (all P <  0.001). In multivariate regression analysis, independent of age and Maze procedure, concomitant TAP was associated with postoperative RV volume reduction (P <  0.001), improvement of RV ejection fraction (P <  0.001), and relieved postoperative functional TR severity (P = 0.025). Conclusions Our results suggest that concomitant TAP could improve RV remodeling and function for rheumatic mitral valve disease patients, while those with mild preoperative functional TR who had isolated MVR might experience RV dilation and deterioration of RV function at follow-up. Concomitant surgery for functional TR could be considered for patients undergoing MVR with rheumatic mitral valve disease.

scholarly journals Effects of right ventricular morphology and function on outcomes of patients with degenerative mitral valve disease

2014 ◽  
Vol 148 (5) ◽  
pp. 2012-2020.e8 ◽  
Author(s):  
Ying Ye ◽  
Ravi Desai ◽  
Lina M. Vargas Abello ◽  
Jeevanantham Rajeswaran ◽  
Allan L. Klein ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Right Ventricular ◽  
Mitral Valve Disease ◽  
Valve Disease ◽  
And Function

scholarly journals Long-term follow-up of atrial contraction after the maze procedure in patients with mitral valve disease

2001 ◽  
Vol 37 (6) ◽  
pp. 1622-1627 ◽  
Author(s):  
Satoshi Yuda ◽  
Satoshi Nakatani ◽  
Yoshio Kosakai ◽  
Masakazu Yamagishi ◽  
Kunio Miyatake
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Disease ◽  
Valve Disease ◽  
Maze Procedure ◽  
Atrial Contraction ◽  
Long Term Follow Up

CMR fast-SENC segmental intramyocardial LV strain monitors decline in heart function before ejection fraction in patient with mitral valve disease

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Montenbruck ◽  
S Kelle ◽  
S Esch ◽  
A.K Schwarz ◽  
S Giusca ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Ejection Fraction ◽  
Cardiac Function ◽  
Mitral Valve Disease ◽  
Heart Function ◽  
Global Longitudinal Strain ◽  
Image Plane ◽  
Valve Disease ◽  
Peak Strain ◽  
Regional Dysfunction

Abstract Background Ejection fraction is the standard metric to analyze cardiac function in the left (LV) or right (RV) ventricles. However, these global metrics are not able to characterize patients in which the heart compensates for regional dysfunction. More sensitive metrics are needed to detect subclinical regional dysfunction before cardiac remodeling results in changes in ejection fraction (EF) and global longitudinal strain (GLS). Fast-SENC intramyocardial strain (fSENC) is a unique cardiac magnetic resonance imaging (CMR) modality that measures intramyocardial contraction in 1 heartbeat per image plane. This prospective registry compares segmental fSENC to standard CMR calculations (e.g. LVEF, volumes, mass, etc.) in patients with mitral valve disease. Methods A single center, prospective registry of CMR scans acquired with a 1.5T scanner were evaluated for standard CMR calculations as well as fSENC scans. Intramyocardial LV & RV strain was quantified with MyoStrain software. Three short axis scans (basal, midventricular, & apical) were used to calculate peak strain in 16 LV & 6 RV longitudinal segments while three long axis scans (2-, 3-, & 4-chamber) were used to calculate 21 LV & 5 RV circumferential segments. Results A total of 493 scans in 424 patients with moderate or severe mitral regurgitation were included in the study. Patients had an average (± stdev) age of 60 (15) yrs and BMI of 27 (4) kg/m2; 63% had arterial hypertension, 19% diabetes mellitus, 10% atrial fibrillation, 15% pulmonary disease, and 32% coronary artery disease. Figure 1 shows the non-linear relationship between segmental fSENC strain (% of normal LV segments ≤−17%) versus LVEF (R=0.81). Conclusion Segmental fSENC detects subclinical LV dysfunction before changes in LVEF. Evaluating segmental longitudinal and circumferential fSENC peak strain provides an alternative metric that shows consistent changes in cardiac function in patients with mitral valve disease irrespective of global calculations that are dependent on loading conditions. Funding Acknowledgement Type of funding source: None

Impact of tricuspid repair on surgical death in patients undergoing mitral valve surgery due to rheumatic disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
T Viana ◽  
R M Vieira De Melo ◽  
D N V Da Silva ◽  
G P Santana ◽  
M L N De Paula ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Tricuspid Regurgitation ◽  
Mitral Valve Disease ◽  
Right Heart Failure ◽  
Valve Disease ◽  
Surgical Mortality ◽  
Tricuspid Annuloplasty ◽  
The Impact ◽  
Tricuspid Repair

Abstract Introduction Observational studies differ on the impact of performing tricuspid repair on surgical mortality. Some studies demonstrate increased surgical mortality related to right ventricular failure and circulatory shock, while there are other studies that evidence improvement in quality of life and signs of right heart failure in the long time. Objective To evaluate the impact on surgical mortality of concomitant tricuspid annuloplasty in patients undergoing cardiac surgery for rheumatic mitral valve disease, who have moderate to severe tricuspid regurgitation. Methods This is a prospective cohort from January 1, 2017 to December 30, 2020. All patients over 18 years of age who underwent cardiac surgery to correct rheumatic mitral valve disease with moderate to significant tricuspid regurgitation were included. The primary outcome was 30-days mortality. Results 165 patients were included, 98 (59.4%) underwent tricuspid valve annuloplasty. The mean age was 46, 5 (±12) years, the median of Euroscore II was 2,33%. The 30-days mortality was 17 (10.3%) and there was no difference between the groups submitted or not to tricuspid repair: 12 (12.2%) versus 5 (7.5%); p=0.44, respectively. In the multivariate analysis involving seven variables with a potential prediction of death in 30 days, tricuspid repair had no association with death, RR 2,4 (0,5 – 8,3); p=0.27. Conclusion In patients with rheumatic heart disease undergoing cardiac surgery for rheumatic mitral valve disease, perform tricuspid annuloplasty in individuals who had moderate to severe tricuspid insufficiency was not associated with increased surgical mortality. FUNDunding Acknowledgement Type of funding sources: None.

A modified maze procedure performed only on the left atrium for chronic atrial fibrillation associated with mitral valve disease: Report of a case

Surgery Today ◽  
1996 ◽  
Vol 26 (2) ◽  
pp. 135-137 ◽  
Author(s):  
Taijiro Sueda ◽  
Hiroo Shikata ◽  
Kazumasa Orihashi ◽  
Norimasa Mitsui ◽  
Hideyuki Nagata ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Left Atrium ◽  
Mitral Valve Disease ◽  
Chronic Atrial Fibrillation ◽  
Valve Disease ◽  
Maze Procedure
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