title: Transient severe mitral regurgitation after mitral valve repair is associated with a poor clinical outcome: a small case series.
abstract: BACKGROUND
  During mitral valve repair, patients with transesophageal echo-detected immediate postoperative systolic anterior motion of the mitral valve (SAM) and mitral regurgitation (MR) are successfully medically managed. They have been shown to do well in a short-term follow-up. However, the long-term outcome has not been investigated. The objective of this project was to investigate the long-term outcome of these patients.
  
  
  METHODS
  This is an observational, retrospective study of 385 patients who underwent MVR. All cases of SAM and MR in this report were successfully medically managed with conservative therapy preventing the need for immediate surgical reintervention. Patients were divided into two groups based on the severity of MR. Group I had grade <or= 2 + MR (<moderate) and Group II had >or= 3+(moderate or severe). Repeat MV surgical procedure or admission to the hospital for congestive heart failure with New York Heart Association (NYHA) Class III or Class IV was identified as a poor outcome.
  
  
  RESULTS
  Twelve patients (3.1 %) were identified as having SAM with MR, which was medically managed intraoperatively. Patients were followed an average of 35 months. There were four patients (33.3%) in Group II. None of the eight patients (0%) in Group I had a poor outcome whereas three of the four patients (75%) in Group II had a poor outcome (OR = 3; P value = 0.018).
  
  
  CONCLUSIONS
  These data suggest that despite the immediate improvement in MR and SAM, it is the degree of transient MR that further stratifies patients into good or poor long-term outcomes.
authors.affiliation: University of Arizona, Sarver Heart Center, Tucson, Arizona, USA. vsorrell@email.arizona.edu
authors.forename: Vincent L
authors.initials: VL
authors.lastname: Sorrell
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Habibzadeh
authors.forename: Nishant
authors.initials: N
authors.lastname: Kalra
authors.forename: W Randolph
authors.initials: WR
authors.lastname: Chitwood
mesh_terms: D006350:Heart Valve Prosthesis; D006801:Humans; D008137:Longitudinal Studies; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography