Hemodynamic predictors of outcome in patients undergoing valve replacement.

Carabello, Blasé A.; Williams, Harold H.; Gash, Arnold K.; Kent, Robert L.; Belber, D; Maurer, Alan H.; Siegel, Jeffrey A.; Blasius, K M; Spann, James F.

doi:10.1161/01.cir.74.6.1309

Cited by 133 publications

(31 citation statements)

References 41 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The derivation of the end-systolic stiffness constant is presented in the Appendix. Stressshortening relations also have been used to examine left ventricular function (9,23,24). Ejection fraction is dependent upon preload, contractile function, and afterload.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Depressed contractile function due to canine mitral regurgitation improves after correction of the volume overload.

Nakano

Swindle²,

Spinale³

et al. 1991

J. Clin. Invest.

View full text Add to dashboard Cite

It is known that long-standing volume overload on the left ventricle due to mitral regurgitation eventually leads to contractile dysfunction. However, it is unknown whether or not correction of the volume overload can lead to recovery of contractility. In this study we tested the hypothesis that depressed contractile function due to volume overload in mitral regurgitation could return toward normal after mitral valve replacement. Using a canine model of mitral regurgitation which is known to produce contractile dysfunction, we examined contractile function longitudinally in seven dogs at baseline, after 3 mo of mitral regurgitation, 1 mo after mitral valve replacement, and 3 mo after mitral valve replacement.After 3 mo of mitral regurgitation (regurgitant fraction 0.62±0.04), end-diastolic volume had nearly doubled from 68±6.8 to 123±12

show abstract

Section: Methodsmentioning

confidence: 99%

“…Once ejection fraction falls after mitral valve repair or replacement it remains persistently diminished (9,10). Why ejection performance is persistently reduced is unclear but it is probably either due to persistent contractile dysfunction or due to persistently elevated afterload, decreased preload, or a combination of all three.…”

Section: Introductionmentioning

confidence: 99%

Depressed contractile function due to canine mitral regurgitation improves after correction of the volume overload.

Nakano

Swindle²,

Spinale³

et al. 1991

J. Clin. Invest.

View full text Add to dashboard Cite

show abstract

“…This can progress to the extent that the full benefit of surgical correction of the regurgitant lesion, in terms of recovery of LV function and improved survival, can no longer be achieved. 244,[247][248][249][250][251][252][253][254][255][256] A large number of studies have identified LV systolic function and end-systolic size as the most important determinants of survival and postoperative LV function in patients undergoing AVR for chronic AR. 235, Studies of predictors of surgical outcome are listed in Table 13.…”

Section: Pathophysiologymentioning

confidence: 99%

2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease

Bonow¹,

Carabello²,

Chatterjee³

et al. 2008

Circulation

910

259

View full text Add to dashboard Cite

“…In order to normalize ESWS, we also calculated ESWS/ESVI ratio [21]. ESWS/ESVI is one of the most helpful predictors in estimating LV function without relation to preload or afterload [22,23].…”

Section: Operative Techniquesmentioning

confidence: 99%

An Evaluation of Left Ventricular Function after Surgery for Pure Mitral Regurgitation Using Dobutamine-stress Echocardiography. Should the Mitral Complex Be Preserved?

Oda

1999

Kurume Med. J.

View full text Add to dashboard Cite

Summary: To evaluate the importance of preserving the mitral complex, clinical outcomes and postoperative left ventricular (LV) functions of 175 patients with pure mitral regurgitation (MR) were analyzed. They were divided into three groups; patients who had conventional mitral valve replacement (cMVR; n=47), posterior mitral leaflet preserved MVR (pMVR; n=66) or mitral valvuloplasty (MVP; n=62). There was no operative death or hospital death in this study. The actuarial survival rate was 85.2% in cMVR, 78.5% in pMVR, and 84.7% in MVP at 10 years after operation. The actuarial freedom from reoperation 10 years postoperatively was 100% in cMVR, 97.9% in pMVR, 85.8% in MVP. The actuarial freedom from thromboembolism (TE) at 10 years was 92.2% in cMVR, 87.1% in pMVR, 93.5% in MVP. Freedom from all types of events including non-cardiac death was 78.3% in cMVR, 64.8% in pMVR, 65.3% in MVP at 10 years, respectively. Pre-and postoperative LV function was evaluated using echocardiography. Patients with MVP had better LV performance than those with MVR. However, there was no significant difference between the cMVR and pMVR groups. For further estimation of postoperative LV function, dobutaminestress echocardiography (DSE) was performed. The results of DSE revealed that the LV contractility in MVP was obviously better than those in MVR groups especially in systole. The change in ejection fraction (EF) from baseline to peak dobutamine stress in the pMVR group was significantly greater than in cMVR. This study supports the concept that the preservation of continuity between the mitral annulus and papillary muscle plays an important role in clinical outcome and postoperative LV function. In conclusion, MVP should be a first choice as an operative method for pure MR when technically feasible. When it is impossible to perform MVP, pMVR, not cMVR, should be the next choice. This study suggests that preservation of papillary muscle-mitral annular continuity during mitral valve surgery for pure MR is beneficial to LV systolic function.

show abstract

Hemodynamic predictors of outcome in patients undergoing valve replacement.

Cited by 133 publications

References 41 publications

Depressed contractile function due to canine mitral regurgitation improves after correction of the volume overload.

Depressed contractile function due to canine mitral regurgitation improves after correction of the volume overload.

2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease

An Evaluation of Left Ventricular Function after Surgery for Pure Mitral Regurgitation Using Dobutamine-stress Echocardiography. Should the Mitral Complex Be Preserved?

Contact Info

Product

Resources

About