Systematic reductive annuloplasty of the mitral and tricuspid valves in patients with end-stage ischemic dilated cardiomyopathy

Autor: Živojin S. Jonjev M.D., Mikloš Fabri, Ninoslav D. Radovanović, Snežana Popović, Milan Mijatov M.D.
Rok vydání: 2007
Předmět:
Male
Time Factors
medicine.medical_treatment
Myocardial Ischemia
Blood Pressure
Coronary Artery Disease
Doppler echocardiography
Coronary artery disease
Tricuspid Valve Insufficiency
Medicine
Prospective Studies
Coronary Artery Bypass
Heart transplantation
Heart Valve Prosthesis Implantation
Ejection fraction
medicine.diagnostic_test
Mitral Valve Insufficiency
Dilated cardiomyopathy
Stroke volume
Middle Aged
Echocardiography
Doppler
medicine.anatomical_structure
Treatment Outcome
Research Design
cardiovascular system
Cardiology
Female
Cardiology and Cardiovascular Medicine
Pulmonary and Respiratory Medicine
Adult
Cardiomyopathy
Dilated
medicine.medical_specialty
Internal medicine
Humans
cardiovascular diseases
Aged
Analysis of Variance
business.industry
Stroke Volume
medicine.disease
Survival Analysis
Surgery
Ventricle
Chronic Disease
Vascular Resistance
business
Echocardiography
Transesophageal
Follow-Up Studies
Zdroj: Journal of cardiac surgery. 22(2)
ISSN: 0886-0440
Popis: Objective: Patients with ischemic dilated cardiomyopathy exhibit extensive remodeling of the left ventricle, annular dilation, and significant mitral and tricuspid regurgitation. These changes increase per operative morbidity and mortality, and emphasize patient candidacy for heart transplantation. The aim of this study is to show immediate and long-term results after reductive annuloplasty of double (mitral and tricuspid) orifices, performed at the time of coronary artery bypass grafting, as an alternative to heart transplantation. Methods: There were 226 consecutive patients (205 males, 21 females) with ischemic dilated cardiomyopathy, mean ejection fraction below 30%[(26.6 ± 3.1)%], and mean left ventricle end-diastolic internal diameter greater than 7.0 cm (7.3 ± 0.3 cm). In addition to myocardial revascularization, Carpentier's mitral annuloplasty and posterior semicircular reductive annuloplasty were performed in 37 and 189 patients, respectively. In all 226 patients, a modified De Vega's tricuspid annuloplasty was performed. Results: Postoperative 30-day mortality was 7.5% (17 patients). Survival rates after 5 and 10 years were (61.5 ± 4.0)% and (38.05 ± 8.0)%, respectively. Conclusion: Reductive annuloplasty of mitral and tricuspid orifices performed at the time of myocardial revascularization could be beneficial in selective patients with ischemic dilated cardiomyopathy. Results indicate that this method should not be recognized as a valve repair, but ventricular repair procedure also.
Databáze: OpenAIRE
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