scholarly journals Demographic and Clinical Features in Patients with Mitral Insufficiency of Ischemic Genesis

2020 ◽  
pp. 29-32
Author(s):  
S. A. Rudenko ◽  
S. V. Potashev ◽  
A. V. Rudenko
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Mitral Regurgitation ◽  
Functional Status ◽  
Heart Attack ◽  
Nyha Class ◽  
Ischemic Mitral Regurgitation ◽  
Mitral Insufficiency ◽  
Shortness Of Breath ◽  
Class Iii

Myocardial infarction is often associated with ischemic mitral regurgitation. In most patients, ischemic mitral regurgitation develops gradually due to remodeling of the ischemic myocardium and changes in hemodynamics in the left ventricle. Ischemic mitral regurgitation is associated with heart diseases and mortality and is therefore considered an unfavorable prognostic factor. The aim. To study the features of demographic data and the clinical condition of patients with mitral regurgitation of ischemic genesis. Materials and methods. From January 2012 to December 2019, 292 patients with ischemic mitral insufficiency underwent surgical intervention at the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine. Results and Discussion. Among patients with mitral regurgitation of ischemic genesis, the majority are men (78.8%). Women suffer from this pathology much less often (21.2%). The mean age of patients with mitral regurgitation of ischemic genesis was 61.9 ± 8.2 years. The proportion of patients with hypertension was almost half of the total number of patients. Every fourth patient suffered from diabetes mellitus (25.7%). In this group, 64.1% (187) patients had a history of myocardial infarction. The majority of patients, 49.3% (144), sought surgery after the first myocardial infarction, 11.0% (32) – after the second heart attack, and in 11 (3.8%) mitral regurgitation occurred only after the third heart attack. Shortness of breath complaints were reported in 249 (85.3%) patients. In most cases (61.3%), shortness of breath occurred only during exercise. Another 70 (24.0%) patients suffered from it even at rest. In this group, 55.1% of patients were classified as NYHA class III–IV. The functional status of 57 (19.5%) patients was so impaired that they were classified as NYHA class IV; 23.6% (69) of patients suffered from IIb degree, and one patient from III degree chronic circulatory insufficiency. Conclusions. Mitral regurgitation of ischemic genesis occurs more often in men (78.8%) of working age (61.1 ± 8.4 years). It leads to a significant reduction in functional status (55.1% of patients were classified as NYHA class III–IV) and physical activity (53.8%). Among the comorbidities, hypertension (47.3%) and diabetes mellitus (25.7%) are the most common.

scholarly journals Surgical treatment of ishemic mitral regurgitation: Repair, replacement or revascularization alone?

2010 ◽  
Vol 138 (7-8) ◽  
pp. 425-429
Author(s):  
Mile Vranes ◽  
Milos Velinovic ◽  
Mladen Kocica ◽  
Aleksandar Mikic ◽  
Svetozar Putnik ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Nyha Class ◽  
Heart Association ◽  
Long Term Results ◽  
Surgical Approaches ◽  
Mitral Insufficiency ◽  
Class Iii ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Introduction. Treatment of ischemic mitral regurgitation in patients that require revascularization of myocardium is still debatable. Objective. The aim of this study was to compare three surgical approaches: valve repair and revascularization; valve replacement and revascularization, and revascularization alone. Methods. In 2006 and 2007 at the Institute for Cardiovascular Diseases, Clinical Centre of Serbia, Belgrade, 1,040 patients with coronary disease underwent surgery. Forty-three patients (4.3%) had also mitral insufficiency 3-4+. The patients were examined clinically, echocardiographically and haemodynamically. In group I there were 14 (32.3%) patients, in group II 16 (37.2%) patients and in group III 3 (30.5%) patients. Ninetythree per cent of patients were classified as New York Heart Association (NYHA) class III and IV, and three (7%) patients had congestive heart weakness with ejection fraction ?30%. The decision as to surgical procedure was made by the surgeon. Postoperatively, patients were checked clinically and echocardiographically after 3, 6 and 12 months. The follow-up period was approximately 15 months (8-20). Results. Hospital mortality for the whole group was 6.9% (3 patients). In group I mortality was 14.2% (2 patients), in group II 6.25% and in group III there was no mortality. Long term results, up to 15 months, showed 100% survival in groups I and II, and in group III one patient died (7.7%). Conclusion. Short term results up to 30 days were best in group III, but longer term results were better in groups I and II.

Abstract 2068: Systematic Undersized Rigid Ring Decreases Recurrence Rate Following Repair of Ischemic Mitral Valve

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Raphaël Fontaine ◽  
Denis Bouchard ◽  
Philippe Demers ◽  
Raymond Cartier ◽  
Michel Carrier ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Recurrence Rate ◽  
Nyha Class ◽  
High Recurrence Rate ◽  
Class Iii ◽  
Term Survival ◽  
Rigid Ring

Introduction: Chronic ischemic mitral regurgitation (MR) has been associated with poor long-term survival. Suboptimal midterm results have been a growing concern in the surgical community. In recent years, our approach to repair those valves has evolved to a standardized technique using complete, rigid and small annuloplasty rings. This study aims to compare this systematic approach with our prior experience from 1996 –2001 where recurrent MR rate was high. Methods: 129 patients underwent repair for pure ischemic mitral valve regurgitation between 2002 and 2005 at our institution. Of these patients, 99 had clinical and echographic follow-up. These patients were compared to the 1996 –2001 cohort of 73 patients. Results: Preoperatively, 84% of patients were in NYHA class III or IV, 17% had moderate MR, 83% had moderate-severe to severe MR. Sixteen were redo operations, mostly of previous CABG. All patients except one were treated with a complete rigid ring (Annuloflo 46.5%, Physioring 34.9%, Etlogix 13.9%, others 3.8%). Ring size was: 24 (0.8%); 26 (55.8%); 28 (38%); or 30 (4.5%). Mortality was 8.5% at 30 days, 14.7% at 1 year and 17.8% at 2 years. Immediate postoperative regurgitation was absent or trace in all patients. Freedom from reoperation was 97%. Mean postoperative NYHA class was 1.15 at a mean follow-up of 28 months. Recurrent moderate mitral regurgitation (2+) was 15.34%, severe mitral regurgitation (3+ to 4+) was 13.4% at a mean follow-up of 16 months. In the 73 patients from the period 1996 –2001 at the same echo follow-up time, the moderate and severe recurrence were: 37% and 21%. The decrease in the recurrence rate was highly significant (p=0.001). Conclusion: A more standardized approach to ischemic mitral valve repair has improved the high recurrence rate previously reported by our group. Long-term follow-up is necessary to confirm these findings.

scholarly journals Impact of Papillary Muscle Infarction on Ischemic Mitral Regurgitation Assessed by Magnetic Resonance Imaging

2017 ◽  
Vol 190 (01) ◽  
pp. 42-50 ◽  
Author(s):  
Christiane Bretschneider ◽  
Hannah-Klara Heinrich ◽  
Achim Seeger ◽  
Christof Burgstahler ◽  
Stephan Miller ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Mitral Regurgitation ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Papillary Muscle ◽  
Left Ventricular ◽  
Ischemic Mitral Regurgitation ◽  
Chronic Myocardial Infarction ◽  
End Diastolic Volume ◽  
Significant Difference

Objective Ischemic mitral regurgitation is a predictor of heart failure resulting in increased mortality in patients with chronic myocardial infarction. It is uncertain whether the presence of papillary muscle (PM) infarction contributes to the development of mitral regurgitation in patients with chronic myocardial infarction (MI). The aim of the present study was to assess the correlation of PM infarction depicted by MRI with mitral regurgitation and left ventricular function. Methods and Materials 48 patients with chronic MI and recent MRI and echocardiography were retrospectively included. The location and extent of MI depicted by MRI were correlated with left ventricular function assessed by MRI and mitral regurgitation assessed by echocardiography. The presence, location and extent of PM infarction depicted by late gadolinium enhancement (LGE-) MRI were correlated with functional parameters and compared with patients with chronic MI but no PM involvement. Results PM infarction was found in 11 of 48 patients (23 %) using LGE-MRI. 8/11 patients (73 %) with PM infarction and 22/37 patients (59 %) without PM involvement in MI had ischemic mitral regurgitation. There was no significant difference between location, extent of MI and presence of mitral regurgitation between patients with and without PM involvement in myocardial infarction. In 4/4 patients with complete and in 4/7 patients with partial PM infarction, mitral regurgitation was present. The normalized mean left ventricular end-diastolic volume was increased in patients with ischemic mitral regurgitation. Conclusion The presence of PM infarction does not correlate with ischemic mitral regurgitation. In patients with complete PM infarction and consequent discontinuity of viable tissue in the PM-chorda-mitral valve complex, the probability of developing ischemic mitral regurgitation seems to be increased. However, the severity of mitral regurgitation is not increased compared to patients with partial or no PM infarction. Key points  Citation Format

Ischemic Mitral Regurgitation and Non-ST-Segment Elevation Acute Myocardial Infarction: Long-Term Prognosis

2009 ◽  
Vol 62 (11) ◽  
pp. 1267-1275 ◽  
Author(s):  
Iván Javier Núñez Gil ◽  
Leopoldo Pérez de Isla ◽  
Juan Carlos García-Rubira ◽  
Antonio Fernández-Ortiz ◽  
Juan José González Ferrer ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Mitral Regurgitation ◽  
Ischemic Mitral Regurgitation ◽  
St Segment Elevation ◽  
St Segment ◽  
Long Term Prognosis ◽  
Elevation Acute Myocardial Infarction

scholarly journals A Coronary Conundrum: Papillary Muscle Rupture and Ischemic Mitral Regurgitation Secondary to Coronary Thromboembolism in Antiphospholipid Syndrome

2019 ◽  
Vol 7 ◽  
pp. 232470961984224
Author(s):  
Amar Shere ◽  
Pradyumna Agasthi ◽  
Farouk Mookadam ◽  
Sudheer Konduru ◽  
Reza Arsanjani
Keyword(s):  
Myocardial Infarction ◽  
Mitral Regurgitation ◽  
Antiphospholipid Syndrome ◽  
Papillary Muscle ◽  
Rare Complication ◽  
Autoimmune Disorder ◽  
Ischemic Mitral Regurgitation ◽  
Papillary Muscle Rupture ◽  
Muscle Rupture ◽  
Uncommon Case

Antiphospholipid syndrome (APS) is an autoimmune disorder that has a strong propensity for a hypercoagulable state and is known to be associated with venous and arterial thromboembolism. We describe an uncommon case of APS in the setting of non-Hodgkin’s lymphoma, with thromboembolism, and a rare complication after an uncommon etiology of myocardial infarction. This case highlights the importance of early and appropriate type of anticoagulation to reduce the morbidity and mortality in patients with APS.

Impact of Infarct Location on Development of Ischemic Mitral Regurgitation in Patients with Acute Myocardial Infarction

2014 ◽  
Vol 20 (10) ◽  
pp. S200
Author(s):  
Kitae Kim ◽  
Shuichiro Kaji ◽  
Takeshi Kitai ◽  
Tomoko Tani ◽  
Makoto Kinoshita ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Mitral Regurgitation ◽  
Ischemic Mitral Regurgitation
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