Echocardiographic assessment of anatomic lesions predicts surgical strategy in mitral regurgitation.
OBJECTIVE
In the present study, we evaluate our ability to predict surgical procedure repair or replacement using preoperative echocardiography.


METHODS
The reports from transthoracic echocardiographic examinations of 298 patients were analyzed and the gross anatomic lesions and the mechanisms involved were classified into one of three main groups (functional with normal valves, organic degenerated with hypermobile valve or organic degenerated without hypermobility).


RESULTS
It was possible to assess the likelihood of repair in 226 patients (76%). The criteria used were institution based and reflect the surgical procedures during the study period (1995-1999). The proportion of patients undergoing repair was 58%. In patients with a high likelihood, repair was performed in 86%. The corresponding figures in the intermediate- and low-likelihood groups were 63 and 23%, respectively. Hypermobility in the posterior leaflet and functional mitral regurgitation led to repair in the majority of patients, while patients with hypermobility in the anterior or both valves more frequently underwent replacement.


CONCLUSIONS
We conclude that it is possible to identify patients with a high likelihood of repair using transthoracic echocardiography.
Bech-Hanssen
Odd
O
Clinical Psychology, Sahlgrenska University Hospital, Götegorg, Sweden. odd.bech-hanssen@klinfys.gu.se
Rydén
Tina
T
Lepore
Vincenzo
V
Wandt
Birger
B
Jeppsson
Anders
A
D000368:Aged; D001026:Coronary Artery Bypass; D004452:Echocardiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000473:pathology*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery