Mitral stenosis after mitral valve repair for non-rheumatic mitral regurgitation

Ibrahim, Mohamed F.; David, Tirone E.

doi:10.1016/s0003-4975(01)03305-7

Cited by 65 publications

(45 citation statements)

References 7 publications

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“…There is hardly any data in the literature to support this as the four patients who have been reported earlier were above 50 years of age. 2 In contrast both of our patients were young.…”

Section: Discussioncontrasting

confidence: 61%

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Mitral Stenosis After Duran Ring Annuloplasty for Non-rheumatic Mitral Regurgitation—A Foreign Body Response?

Bisoi

Rajesh

Talwar

et al. 2006

Heart, Lung and Circulation

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“…There is hardly any data in the literature to support this as the four patients who have been reported earlier were above 50 years of age. 2 In contrast both of our patients were young.…”

Section: Discussioncontrasting

confidence: 61%

“…1 Mitral stenosis is rare after mitral valve repair using a ring annuloplasty for myxomatous mitral regurgitation. 2 We report two cases of mitral stenosis after Duran ring (Medtronic, Minneapolis, MN, USA) annuloplasty for myxomatous mitral regurgitation.…”

Section: Itral Valve Repair Is the Surgery Of Choice For Patientsmentioning

confidence: 98%

Mitral Stenosis After Duran Ring Annuloplasty for Non-rheumatic Mitral Regurgitation—A Foreign Body Response?

Bisoi

Rajesh

Talwar

et al. 2006

Heart, Lung and Circulation

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“…32 The type of mitral annuloplasty (rigid ring such as Carpentier or flexible as Duran or simply a posterior band as Cosgrove) had no effect on late recurrent MR; however, we found that the Duran ring was a risk factor for reoperation on the MV largely because of 5 patients who developed mitral stenosis due to excessive pannus on the annuloplasty ring with extension into the leaflets. 33 We did not encounter this problem with the Carpentier ring or the Cosgrove band in our patients.…”

mentioning

confidence: 57%

Late Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease

et al. 2013

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Background-The pathological spectrum of degenerative diseases of the mitral valve (MV) that causes mitral regurgitation (MR) is broad, and there is limited information on late outcomes of MV repair in various subgroups of patients and pathologies. This study examines this issue. Methods and Results-All 840 patients who had MV repair for MR due to degenerative diseases from 1985 to 2004 were prospectively followed with clinical and echocardiographic evaluations at biennial intervals up to 26 years, median of 10.4 years. Clinical, hemodynamic, and pathological variables were evaluated for their association with outcomes. Age, left ventricular ejection fraction, and functional class were predictors of late cardiac-and valve-related deaths by multivariable analysis. MV repair failed to restore life span to normal in patients with functional class IV. Thirty-eight patients had repeat MV surgery, and the probability of reoperation at 20 years was 5.9%. During the follow-up, recurrent severe MR developed in 37 patients, and moderate MR developed in 61. Age, isolated prolapse of the anterior leaflet, the degree of myxomatous changes in the MV, lack of mitral annuloplasty, and duration of cardiopulmonary bypass were associated with increased risk of recurrent MR. At 20 years, the freedom from recurrent severe MR was 90.7%, and the freedom from moderate or severe MR was 69.2%. Conclusions-MV

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“…This is different from the late and unusual occurrence of MS years after MV repair because of excessive fibrous tissue at the annular ring extending onto the leaflets. [27][28][29] As there are no prior studies on EMG in patients with MV repair for degenerative MR, we included a control group to establish the normal limits of MV gradients, even though the concept of functional MS has been developed in patients with surgical annuloplasty for ischemic MR showing that a mean diastolic mitral gradient of >3 mm Hg was likely abnormal. [23][24][25][26] The data in our controls provided further evidence that mean diastolic mitral gradient of >3 mm Hg was abnormal and indicative of MS.…”

Section: Discussionmentioning

confidence: 99%

Functional Significance of Elevated Mitral Gradients After Repair for Degenerative Mitral Regurgitation

Chan

Chen

Chan

et al. 2013

Circ: Cardiovascular Imaging

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Background-We have observed that elevated mitral gradients can develop in some patients after mitral valve repair for degenerative mitral regurgitation. Methods and Results-We screened 275 patients who had mitral valve repair involving >1 leaflet scallop between October 2001 and July 2010. Mitral valve hemodynamics were assessed at rest and at peak exercise using the cycle ergometer. B-type natriuretic peptide levels were measured at rest and after exercise. The patients also performed a 6-minute walk test and short-form 36-Item Health Survey questionnaire. We enrolled 110 patients, with resting mean mitral diastolic gradient of ≤3 mm Hg in 35 patients (group 1) and >3 mm Hg indicative of elevated mitral gradients in 75 patients (group 2). Posterior mitral leaflet plication (P=0.04) and the use of a complete mitral annuloplasty ring (P<0.0001) were associated with elevated mitral gradients. Group 2 patients had larger left atrial volume (P=0.02), higher mitral gradients at peak exercise and higher pulmonary artery systolic pressure at rest and at peak exercise, and lower exercise capacity (101±40 versus 122±51 W; P=0.02). Group 2 patients also had higher B-type natriuretic peptide levels and lower scores in 3 short-form 36-Item Health Survey health concepts. Multivariate regression analyses showed that mitral valve area was an independent predictor of maximum exercise capacity (P=0.003). Conclusions-After mitral valve repair for degenerative mitral regurgitation, elevated mitral gradients is not uncommon and is associated with worse intracardiac hemodynamics, higher B-type natriuretic peptide levels, lower exercise capacity, and poorer quality of life. Further refinement in the surgical technique may reduce the incidence of this complication. (Circ Cardiovasc Imaging. 2013;6:1041-1047.)Key Words: exercise capacity ◼ mitral valve insufficiency ◼ mitral valve repair ◼ mitral valve stenosis ◼ quality of life

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Mitral stenosis after mitral valve repair for non-rheumatic mitral regurgitation

Cited by 65 publications

References 7 publications

Mitral Stenosis After Duran Ring Annuloplasty for Non-rheumatic Mitral Regurgitation—A Foreign Body Response?

Mitral Stenosis After Duran Ring Annuloplasty for Non-rheumatic Mitral Regurgitation—A Foreign Body Response?

Late Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease

Functional Significance of Elevated Mitral Gradients After Repair for Degenerative Mitral Regurgitation

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