TY - JOUR
T1 - Echocardiographic Predictors of Successful Versus Unsuccessful Mitral Valve Repair in Ischemic Mitral Regurgitation
AU - Kongsaerepong, Vorachai
AU - Shiota, Maiko
AU - Gillinov, A. Marc
AU - Song, Jong Min
AU - Fukuda, Shota
AU - McCarthy, Patrick M.
AU - Williams, Timothy
AU - Savage, Robert
AU - Daimon, Masao
AU - Thomas, James D.
AU - Shiota, Takahiro
N1 - Funding Information:
This study was supported in part by Bangkok Metropolitan Administration, Bangkok, Thailand.
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2006/8/15
Y1 - 2006/8/15
N2 - Mitral valve (MV) annuloplasty is the standard surgical technique for the management of ischemic mitral regurgitation (MR). However, ≤1/3 of patients develop recurrent MR after annuloplasty. Therefore, we sought to identify the preoperative echocardiographic parameters that predict annuloplasty failure in patients with ischemic MR. Intraoperative transesophageal echocardiograms from 365 patients who underwent MV repair for ischemic MR were reviewed. Of the 365 patients, 297 (81%) had satisfactory outcomes with <2+ MR, and 68 (19%) had recurrent MR (≥2+) during a mean follow-up of 269 days. The mitral annular parameters, including mitral annular diameter, tethering height, and tethering area of the mitral leaflets, were determined in 3 different echocardiographic views. On multiple logistic stepwise regression analysis, a higher mitral annular diameter, higher tethering area, and higher MR severity were identified as independent predictors for failure of MV repair (p <0.0001). In conclusion, these results demonstrated that preoperative echocardiographic findings can be used to identify patients with ischemic MR at increased risk of repair failure. These echocardiographic measurements should be used to guide the cardiologist and cardiac surgeon in the choice of MV repair versus replacement in patients with ischemic MR.
AB - Mitral valve (MV) annuloplasty is the standard surgical technique for the management of ischemic mitral regurgitation (MR). However, ≤1/3 of patients develop recurrent MR after annuloplasty. Therefore, we sought to identify the preoperative echocardiographic parameters that predict annuloplasty failure in patients with ischemic MR. Intraoperative transesophageal echocardiograms from 365 patients who underwent MV repair for ischemic MR were reviewed. Of the 365 patients, 297 (81%) had satisfactory outcomes with <2+ MR, and 68 (19%) had recurrent MR (≥2+) during a mean follow-up of 269 days. The mitral annular parameters, including mitral annular diameter, tethering height, and tethering area of the mitral leaflets, were determined in 3 different echocardiographic views. On multiple logistic stepwise regression analysis, a higher mitral annular diameter, higher tethering area, and higher MR severity were identified as independent predictors for failure of MV repair (p <0.0001). In conclusion, these results demonstrated that preoperative echocardiographic findings can be used to identify patients with ischemic MR at increased risk of repair failure. These echocardiographic measurements should be used to guide the cardiologist and cardiac surgeon in the choice of MV repair versus replacement in patients with ischemic MR.
UR - http://www.scopus.com/inward/record.url?scp=33746704349&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33746704349&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2006.02.056
DO - 10.1016/j.amjcard.2006.02.056
M3 - Article
C2 - 16893706
AN - SCOPUS:33746704349
SN - 0002-9149
VL - 98
SP - 504
EP - 508
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 4
ER -