Restrictive annuloplasty and coronary revascularization in ischemic mitral regurgitation results in reverse left ventricular remodeling
| Autor: | Jeroen J. Bax, Robert Dion, Jerry Braun, Michel I.M. Versteegh, Robert J.M. Klautz, Ernst E. van der Wall, Eduard R. Holman, Soeresh Somer, Martin J. Schalij, Eric Boersma |
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| Přispěvatelé: | Cardio-thoracic surgery, Cardiothoracic Surgery, Cardiology |
| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Myocardial Ischemia Postoperative Complications Physiology (medical) Internal medicine Mitral valve medicine Humans cardiovascular diseases Coronary Artery Bypass Ventricular remodeling Aged Ultrasonography Mitral regurgitation Ischemic cardiomyopathy Ejection fraction Ventricular Remodeling business.industry Mitral Valve Insufficiency Stroke Volume Stroke volume Middle Aged medicine.disease Surgery Stenosis medicine.anatomical_structure Treatment Outcome Heart failure Acute Disease Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Bax, J J, Braun, J, Somer, S T, Klautz, R, Holman, E R, Versteegh, M I M, Boersma, E, Schalij, M J, Van Der Wall, E E & Dion, R A 2004, ' Restrictive annuloplasty and coronary revascularization in ischemic mitral regurgitation results in reverse left ventricular remodeling ', Circulation, vol. 110, no. 11 SUPPL., pp. II103-II108 . https://doi.org/10.1161/01.CIR.0000138196.06772.4e Circulation, 110(11 SUPPL.), II103-II108. Lippincott Williams and Wilkins Circulation, 110, 103-108. Lippincott Williams & Wilkins |
| ISSN: | 1524-4539 0009-7322 |
| Popis: | Background— Data on combined coronary artery bypass grafting (CABG) and restrictive annuloplasty in patients with ischemic cardiomyopathy are scarce, and the effect on reverse left ventricular (LV) remodeling is unknown. Methods and Results— 51 patients with ischemic LV dysfunction (LV ejection fraction 31±8%) and severe mitral regurgitation (grade 3 to 4+) underwent CABG and restrictive annuloplasty with stringent downsizing of the mitral annulus (by 2 sizes, Physio-ring, mean size 28±2). Serial transthoracic echocardiographic studies were performed (before surgery and within 3 months and 1.5 years after surgery) to assess mitral regurgitation, transmitral gradient, leaflet coaptation, and left atrial and LV reverse remodeling. Clinical follow-up (New York Heart Association [NYHA] class, survival, events) was assessed at 2-year follow-up. Early operative mortality was 5.6%; at 2-year follow-up, all patients were free of endocarditis and thromboembolism, and 1 needed re-operation for recurrent mitral regurgitation; 2-year survival was 84%. NYHA class improved from 3.4±0.8 to 1.3±0.4 ( P P P P Conclusion— Excellent results of combined restrictive annuloplasty and CABG were obtained. Residual mitral regurgitation was absent/minimal at 2-year follow-up, associated with a significant reduction in left atrial dimension and LV reverse remodeling. |
| Databáze: | OpenAIRE |
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