Ischemic mitral valve repair: correlations between the mechanisms of mitral regurgitation and left ventricular function prior to and following surgery.
OBJECTIVE
To define the mechanisms of ischemic mitral regurgitation (MR) and its correlation with left ventricular (LV) function prior to and 1 year following mitral valve (MV) repair.


METHODS
Fifty-three patients (pts) underwent echocardiographic evaluation of the MR mechanism according to Carpentier's classification; quantification of MR and LV function.


RESULTS
Forty-one, 5% of pts had Type I (annulus dilation), 20, 5% had Type II (commissural prolapse) and 38% had Type IIIb MR (predominant posterior leaflet restriction). Preoperative LV function was slightly better preserved in pts with Type II and IIIb MR. Despite similar MV repair efficiency intraoperatively, after 1 year Type I MR progressed vs the remaining types. LV function, including dimensions, ejection fraction and pulmonary artery pressure had a tendency to worsen in pts with Type I and markedly improved in Type II and IIIb MR.


CONCLUSIONS
Ischemic MR of Type I is associated with more marked LV dysfunction preoperatively, its further deterioration and MR progression after MV repair. Type II and IIIb MR correlates with better preserved LV function preoperatively and its incremental improvement late after surgery.
Vaskelyte
Jolanta
J
Biomedical Research Institute,Department of Cardiology/Cardiosurgery of the Kaunas University of Medicine, Kaunas, Lithuania. jvaskelyte@hotmail.com
Ereminiene
Egle
E
Benetis
Rimantas
R
Zaliunas
Remigijus
R
Sirvinskas
Edmundas
E
D000368:Aged; D018450:Disease Progression; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D013997:Time Factors; D016277:Ventricular Function, Left