Predictors of Mitral Regurgitation Recurrence in Patients With Heart Failure Undergoing Mitral Valve Annuloplasty

Ciarka, Agnieszka; Braun, Jerry; Delgado, Victoria; Versteegh, Michel I.M.; Boersma, Eric; Klautz, Robert J.M.; Dion, Robert; Bax, Jeroen J.; Veire, Nico Van de

doi:10.1016/j.amjcard.2010.03.042

Cited by 151 publications

(90 citation statements)

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“…33 The heterogeneity of our patient population, therefore, is one limitation of the present study. We also used more Sorin-Memo-3D rings compared to the previous studies [16][17][18][19][20] which limits generalization of our results. Compared to the previous investigations, we observed more "unsuccessful" surgical results in this study.…”

Section: Discussionmentioning

confidence: 99%

“…While Lee et al 16 and Serri et al 17 have reported similar results for LVEF, others demonstrated no significant differences in EF between the two groups. [18][19][20] To the knowledge of the authors, there are only two investigations by Ciarka et al 18 and Roshanali et al 21 that evaluated IPMD for predicting results of MVA. Similar to the former study and in contrast to the latter, we found no difference in IPMD between the two groups.…”

Section: Discussionmentioning

confidence: 99%

“…Compared to the previous investigations, we observed more "unsuccessful" surgical results in this study. Although the literature has suggested that, in contradistinction to organic MR, effective surgical treatment of ischemic MR can be challenging, [16][17][18][19][20] that higher rate might have something to do with our surgical technique. This could be considered as a major limitation of our study and might be an important confounding factor for interpreting observed results.…”

Section: Discussionmentioning

confidence: 99%

“…As a convenient tool, TTE has increasingly been used to help surgeons to exclude patients with a high probability of early MVA failure. [16][17][18][19][20] To find some preoperative TTE indices that predict immediate results of MVA, we designed this study with more focusing on some novel parameters.…”

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confidence: 99%

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Novel Echocardiographic Indices as Predictors of Immediate Recurrence after Undersized Ring Annuloplasty for Ischemic Mitral Regurgitation

et al. 2015

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Background and aim: Ischemic mitral regurgitation (IMR) is among the most serious complications of myocardial infarction which doubles the late mortality; mainly treated by undersizing ring annuloplasty. To find some preoperative echocardiographic indices that predict immediate failure of mitral valve annuloplasty (MVA), we designed the present study with more focusing on some novel parameters. Method: Transthoracic echocardiography (TTE) indices of consecutive patients referred with 3+ or 4+ IMR were registered 24 hours before surgery. Thirty days later, a second TTE was performed. According to the results, the patients were categorized as the "successful" group (with 1+ or less mitral regurgitation) and the "unsuccessful" group (with 2+ or higher MR). Preoperative TTE indices were compared among the two groups using suitable statistical tests. Results: Of the total of 126 cases, 68 had successful and 58 had unsuccessful MVA. Statistically significant differences were found between the two groups for left ventricular ejection fraction (LVEF) (P = 0.007), left ventricular end systolic volume (LVESV) (P = 0.044), and basal-interpapillary muscle distance (IPMD) diastolic-to-systolic ratio (DSR) (P = 0.008). Receiver Operating Characteristic analysis demonstrated 37.5%, 3.85 cm 3 , and 1.25, as the best cutoff points for LVEF (P = 0.03, sensitivity: 81%, specificity: 69%), LVESV (P = 0.023, sensitivity: 83%, specificity: 57%), and basal-IPMD DSR (P = 0.001, sensitivity: 100%, specificity: 95%), respectively. Conclusion: Among all TTE indices, LVEF, LVESV, and basal-IPMD DSR were helpful to differentiate between the successful and unsuccessful MVA results. We believe the basal-IPMD DSR as a novel index could be targeted in the future studies. (Echocardiography 2015;32:1339-1346

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Novel Echocardiographic Indices as Predictors of Immediate Recurrence after Undersized Ring Annuloplasty for Ischemic Mitral Regurgitation

et al. 2015

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“…The value of cardiac resynchronization therapy was debated, since the updated ESC HF guidelines state that cardiac resynchronization therapy with pacing/defibrillator should be considered in patients with sinus rhythm, with a QRS duration of ≥150 ms (irrespective of QRS morphology) and an EF of ≤35% to reduce the risk of HF hospitalization and the risk of premature death (level of evidence: Class IIa, level A) [6]. Potential surgical options were discussed, including preoperative predictors of recurrent secondary MR after undersized annuloplasty, including specifically mitral geometry [11]. According to the 2012 ESC/European Society of Cardio thoracic Surgeons guidelines for valve disease [12], indications for surgery remain controversial, mainly because of the persistence and high recurrence rate of MR after valve repair and the absence of evidence that surgery prolongs life.…”

Section: Cardiac Remodelingmentioning

confidence: 99%

A Holistic Approach to Managing a Patient With Heart Failure

Duncan

Cunnington

2013

Future Cardiol.

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Despite varied and complex therapeutic strategies for managing patients with heart failure, the prognosis may remain poor in certain groups. Recognition that patients with heart failure frequently require input from many care groups formed the basis of The British Society of Heart Failure Annual Autumn Meeting in London (UK), in November 2012, entitled: ‘Heart failure: a multidisciplinary approach’. Experts in cardiology, cardiac surgery, general practice, care of the elderly, palliative care and cardiac imaging shared their knowledge and expertise. The 2-day symposium was attended by over 500 participants from the UK, Europe and North America, and hosted physicians, nurses, scientists, trainees and representatives from the industry, as well as patient and community groups. The symposium, accredited by the Royal College of Physicians and the Royal College of Nursing, focused on the multidisciplinary approach to heart failure, in particular, current therapeutic advances, cardiac remodeling, palliative care, atrial fibrillation, heart rate-lowering therapies, management of acute heart failure and the management of patients with mitral regurgitation and heart failure.

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Antegrade percutaneous valve implantation for mitral ring dysfunction, a challenging case

Petronio

Giannini

Guarracino

2012

Cathet Cardio Intervent

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The operative risk for reoperation of degenerated bioprosthetic valves or failing mitral-valve annuloplasty is higher compared with the risks for first isolated native valve repair or replacement (Astor et al., Eur Heart J 2008;29:2382-2387). In the presence of comorbidities, these risks increase exponentially. The recent introduction of transcatheter valve implantation opened new perspectives for the treatment of patients at very high surgical risk. We report a percutaneous mitral valve (MV) implantation using a transatrial approach within a MV ring using the Edwars Sapien XT valve.

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Predictors of Mitral Regurgitation Recurrence in Patients With Heart Failure Undergoing Mitral Valve Annuloplasty

Cited by 151 publications

References 20 publications

Novel Echocardiographic Indices as Predictors of Immediate Recurrence after Undersized Ring Annuloplasty for Ischemic Mitral Regurgitation

Novel Echocardiographic Indices as Predictors of Immediate Recurrence after Undersized Ring Annuloplasty for Ischemic Mitral Regurgitation

A Holistic Approach to Managing a Patient With Heart Failure

Antegrade percutaneous valve implantation for mitral ring dysfunction, a challenging case

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