Left ventricular infarct plication restores mitral function in chronic ischemic mitral regurgitation
| Autor: | Nawwar Al-Attar, Christophe Caussin, Chokri Kortas, S. Ghostine, Siamak Mohammadi, Remi Nottin, Alexis Therasse, Ramzi Ramadan, Alexandre Azmoun |
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| Rok vydání: | 2005 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Heart Ventricles Ischemia Myocardial Ischemia Ventricular Function Left Internal medicine Mitral valve medicine Humans Myocardial infarction cardiovascular diseases Coronary Artery Bypass Ventricular remodeling Papillary muscle Aged Mitral regurgitation business.industry Mitral Valve Insufficiency Middle Aged medicine.disease medicine.anatomical_structure Treatment Outcome Ventricle Echocardiography Heart failure Chronic Disease Cardiology cardiovascular system Mitral Valve Surgery business Cardiology and Cardiovascular Medicine Follow-Up Studies |
| Zdroj: | The Journal of thoracic and cardiovascular surgery. 129(2) |
| ISSN: | 0022-5223 |
| Popis: | Chronic ischemic mitral regurgitation (IMR) is characterized by restricted leaflet closure with increased leaflet tethering caused by displaced attachment of the papillary muscle (PM). Generally, the posterior PM is displaced by ventricular remodeling after posterolateral myocardial infarction. IMR carries a significantly negative prognostic effect for cardiac mortality within 5 years, even in patients without signs of established heart failure. A variety of surgical techniques of repairing or replacing the mitral valve have been advocated. These techniques are generally technically demanding and necessitate opening the left side of the heart. Experimental work on ventricular remodeling through reduction of the left ventricular circumference by plication of the left ventricle (LV) can restore mitral geometry toward a normal level. Recently, an external device that repositions the PM has been shown to reduce IMR without compromising LV function. We report the first 3 cases in human subjects of chronic IMR treated by means of plication of the fibrotic infarct in the posterolateral wall of the LV simultaneously with a coronary revascularization procedure without mitral annuloplasty. |
| Databáze: | OpenAIRE |
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