Influence of Mitral Regurgitation Repair on Survival in the Surgical Treatment for Ischemic Heart Failure Trial

Deja, Marek; Grayburn, Paul A.; Sun, Benjamin; Rao, Vivek; She, Lilin; Krejca, Michał; Jain, Anil; Chua, Yeow Leng; Daly, Richard C.; Senni, Michele; Mokrzycki, Krzysztof; Menicanti, Lorenzo; Oh, Jae K.; Michler, Robert E.; Wróbel, Krzysztof; Lamy, André; Velázquez, Eric J.; Lee, Kerry L.; Jones, Robert H.

doi:10.1161/circulationaha.111.072256

Cited by 214 publications

(128 citation statements)

References 27 publications

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“…Рисунок 3. Динамика показателей качества жизни пациентов в группе изолированного КШ в отдаленном периоде ОРИГИНАЛЬНЫЕ СТАТЬИ § исследования, поддерживающие преимущества анну-лопластики митрального клапана, эти данные получе-ны либо не в рандомизированных исследованиях, либо основаны на результатах лечения пациентов с низкой ФВ ЛЖ [13][14][15][16]. Также есть исследования, опроверга-ющие преимущества дополнительного вмешательства на митральном клапане [4,[17][18][19].…”

Section: Discussionunclassified

Quality of life in patients after surgical treatment of moderate ischemic mitral regurgitation

Chernyavskiy¹,

Рузматов²,

Efendiyev³

et al. 2017

RHJ

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Section: Discussionunclassified

Quality of life in patients after surgical treatment of moderate ischemic mitral regurgitation

Chernyavskiy¹,

Рузматов²,

Efendiyev³

et al. 2017

RHJ

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“…43 Similarly, for ischemic mitral regurgitation, 3D TEE will play an increasing role because there is growing evidence that mitral valve repair at the time of revascularization is associated with improved outcomes. 44 Currently, regardless of the morphoanatomic mechanism of ischemic mitral regurgitation, the majority of surgeons intervene by reducing the mitral annular size with a downsized annuloplasty ring. This simplistic and uniform approach results in suboptimal results because a significant number of patients will experience recurrent mitral regurgitation after repair.…”

Section: D Echocardiography Changes the Operation Performedmentioning

confidence: 99%

Three-dimensional Echocardiography Is Essential for Intraoperative Assessment of Mitral Regurgitation

Tsang

Lang²

2013

Circulation

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Since its introduction, 3-dimensional (3D) transesophageal echocardiography (TEE) has become widely adopted in operating rooms and cardiac catheterization laboratories worldwide. This is because the matrix-array 3D TEE probe allows acquisition of high-quality 3D images in real time with relatively little training. The rapid adoption of this technology has proven that this innovative imaging modality provides additional clinical information beyond that obtained from 2-dimensional (2D) TEE images. These developments have enabled medical centers to create integrated valve programs in which surgeons, interventionalists, and echocardiographers discuss cases and surgical approaches. Response by McCarthy on p 652In particular, 3D TEE has been proven to be superior to 2D TEE in the assessment of both mitral valve anatomy and mitral regurgitation, promoting its use in the operating room (Table 1). [1][2][3] One reason for this superiority is that 3D TEE allows the mitral valve to be displayed en face in an orientation identical to the surgeon's view of the mitral valve intraoperatively. This surgeon's view greatly facilitates communication with cardiac surgeons because they can easily interpret these images.Here, we argue that the widespread acceptance and use of 3D TEE are attributable to the pivotal role this modality plays in the intraoperative assessment of mitral regurgitation. We believe that 3D TEE of the mitral valve is invaluable not only because of the realistic images it provides but also because it improves: 1) lesion localization, 2) identification of the mechanisms causing mitral regurgitation, 3) quantification of the severity of mitral regurgitation, 4) selection of surgical intervention, 5) the choice of the surgeon whose expertise is best suited to perform the operation, 6) guidance of percutaneous mitral valve procedures, and 7) postoperative assessment. 3D Echocardiography of the Mitral ValveAccurate preoperative assessment of the mitral valve is critical in the surgical management of patients with severe mitral regurgitation. This information determines whether the patient should undergo valve repair or replacement, which has implications in terms of timing of surgery and long-term morbidity and mortality. 4 Traditionally, 2D TEE has been used to evaluate mitral valve anatomy. However, 2D TEE requires manual manipulation of the transducer in the esophagus and various degrees of flexion or anteflexion of the probe to acquire the standard mid-esophageal views and to examine all leaflet scallops. Since 2D TEE only provides single plane images, the entire mitral annulus and leaflets are not displayed in a single en face view, making it difficult to identify specific scallops with precision. As well, because the mitral annulus is saddle shaped, distortions of mitral valve anatomy, mitral annular dilatation, or aortic root enlargement may change the orientation of the ultrasound plane in relation to mitral valve apparatus, resulting in scallop misidentification.

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“…They performed a survival analysis of 1,212 patients enrolled in the Surgical Treatment for Ischaemic Heart Failure (STICH) trial to investigate the impact of adding mitral valve repair in a subset of patients with moderate to severe chronic ischemic MR prospectively randomised, in accordance with the study design, to receive CABG or optimised medical therapy [33,34].…”

Section: Figurementioning

confidence: 99%

Surgical management of functional mitral regurgitation in heart failure patients

2013

Cardiovasc Med

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Relevant secondary mitral regurgitation occurs in 35-50% of patients with chronic heart failure and is associated with increased mortality. Surgical management of patients with mitral valve regurgitation and heart failure remains controversial. There are several questions which are not sufficiently clarified because of a lack of prospective randomised controlled trials: (1.) The indication for concomitant mitral valve surgery in patients undergoing coronary artery bypass grafting (CABG) with moderate to severe mitral valve regurgitation; (2.) the management of functional mitral valve regurgitation; (3.) the appropriate surgical strategy: repair or chordal-sparing replacement. SummaryRelevant secondary mitral regurgitation occurs in 35-50% of patients with chronic heart failure and is associated with increased mortality. Surgical management of patients with mitral valve regurgitation and heart failure remains controversial. There are several questions which are not sufficiently clarified because of a lack of prospective randomised controlled trials: (1.) The indication for concomitant mitral valve surgery in patients undergoing coronary artery bypass grafting (CABG) with moderate to severe mitral valve regurgitation; (2.) the management of functional mitral valve regurgitation; (3.) the appropriate surgical strategy: repair or chordal-sparing replacement.

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Influence of Mitral Regurgitation Repair on Survival in the Surgical Treatment for Ischemic Heart Failure Trial

Cited by 214 publications

References 27 publications

Quality of life in patients after surgical treatment of moderate ischemic mitral regurgitation

Quality of life in patients after surgical treatment of moderate ischemic mitral regurgitation

Three-dimensional Echocardiography Is Essential for Intraoperative Assessment of Mitral Regurgitation

Surgical management of functional mitral regurgitation in heart failure patients

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