Mitral valve repair versus replacement for isolated non-ischemic mitral regurgitation in patients with preoperative left ventricular dysfunction. A long-term follow-up echocardiography study.

Autor: Kouris N; Western Attica General Hospital, Athens, Greece. nikoskou@otenet.gr, Ikonomidis I, Kontogianni D, Smith P, Nihoyannopoulos P
Jazyk: angličtina
Zdroj: European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology [Eur J Echocardiogr] 2005 Dec; Vol. 6 (6), pp. 435-42. Date of Electronic Publication: 2005 Apr 02.
DOI: 10.1016/j.euje.2005.01.003
Abstrakt: Unlabelled: The aim of this study was to evaluate LV function, by means of echocardiography, after mitral valve repair (MVr) or mitral valve replacement (MVR) in patients (pts) with chronic degenerative mitral regurgitation (MR) and depressed LV systolic function during a 6-years follow-up (FU) period.
Patients and Methods: Forty-five pts with moderately severe or severe MR and preoperative EFResults: In MVr group, 5 pts died, 5 were lost to FU and 2 pts underwent MVR due to MVr failure. In MVR group, 6 pts died, 3 were lost to FU and 1 was re-operated due to prosthetic valve endocarditis. Atrial fibrillation was similar between the 2 groups. MVr pts demonstrated significant LVEDD decrease postoperatively which was persistent during FU (p<0.05). LVESD also decreased (p<0.05), VTI improved (p<0.05), while FS and EF showed a trend to improve. In MVR pts, LVEDD was decreased (p<0.05) but increased during FU (p<0.05) and LVESD remained high, resulting in a decrease of FS and EF (p<0.05). VTI remained unchanged (p=NS).
Conclusion: MVr in pts with non-ischemic MR and preoperative LV dysfunction achieves better preservation of LV systolic indices than MVR, probably due to preservation of the subvalvular apparatus and LV geometry.
Databáze: MEDLINE
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