Evaluation of the mitral valve leaflet morphology after mitral valve reconstruction with a concept "coaptation length index".
BACKGROUND
In clinical settings, information on morphology of mitral valve leaflet after mitral valve reconstruction is limited.


METHODS
Between January 1996 and June 2000, 36 underwent mitral valve repair for mitral regurgitation (MR). The etiology of mitral insufficiency was prolapse, dilated annulus, and ischemic. Ring annuloplasty was performed in all cases. Mitral valve short-axis dimension (MVd), vertical distance between annular line and closing point (Vd), coaptation length (CL), coaptation length index (CL/MVd) were measured by the two-dimensional transesophageal echocardiography for the present 11 cases.


RESULTS
In 11 cases, residual MR, using a scale from 0 to 4, was 0 in 5 patients, 1 in 4 patients, 2 in 2 patients whose etiology of regurgitation was cardiomyopathy. MVd and Vd decreased significantly (38.7 +/- 6.2 to 27.0 +/- 5.6 mm, 10.1 +/- 7.7 to 6.5 +/- 4.6 mm, respectively). CL and CLI increased significantly (6.4 +/- 2.4 to 11.6 +/- 4.6 mm, 0.16 +/- 0.06 to 0.44 +/- 0.21, respectively). Among those index, only CLI have a statistically significant negative correlation with the degree of residual MR.


CONCLUSIONS
The mitral valve ring annuloplasty produce the morphologic change of mitral apparatus, especially the increase of CLI, which may be one of the main factors in regulation of regurgitation.
Yamauchi
Takashi
T
Department of Cardiovascular Surgery, Labour Wlefare Corporation Osaka Rosai Hospital, Osaka, Japan.
Taniguchi
Kazuhiro
K
Kuki
Satoru
S
Masai
Takafumi
T
Noro
Hiroshi
H
Nishino
Masami
M
Fujita
Shinichi
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome