Isolated undersized mitral annuloplasty for functional mitral regurgitation in non-ischemic dilated cardiomyopathy: reconsideration of the relationship between preoperative coaptation depth and persistent mitral regurgitation.
BACKGROUND
A preoperative coaptation depth (CD) >or=11 mm is apparently a predictive factor for persistent mitral regurgitation (MR) after undersized mitral annuloplasty for functional MR. The results of studies of isolated undersized mitral annuloplasty in non-ischemic dilated cardiomyopathy (DCM) are reported, including the relationship between the preoperative CD and recurrent MR.


RESULTS
Six patients (mean age, 61 years) with severe functional MR in non-ischemic DCM underwent isolated undersized mitral annuloplasty. There were no hospital deaths. At intermediate follow-up of 2.2+/-1.9 years, New York Heart Association functional class improved significantly from 3.3+/-0.5 before surgery to 2.2+/-0.4 after surgery (p=0.0016). At a mean echocardiographic follow-up of 1.9+/-1.7 years, MR grade improved significantly from 4.0+/-0.0 before surgery to 1.0+/-0.6 after surgery (p<0.001). In 4 of 5 patients with a preoperative CD >or=11 mm, functional MR improved to mild or less than mild after surgery.


CONCLUSIONS
Isolated undersized mitral annuloplasty improved clinical symptoms and functional MR in non-ischemic DCM. These results suggest that preoperative CD >or=11 mm does not always predict recurrent MR after isolated undersized mitral annuloplasty for functional MR in cases of non-ischemic DCM.
Miura
Takashi
T
Department of Cardiovascular Surgery, Graduate School of Medicine, Nagasaki University, Nagasaki, Japan. takashiren@yahoo.co.jp
Eishi
Kiyoyuki
K
Yamachika
Shiro
S
Hashizume
Koji
K
Tada
Seiichi
S
Yamane
Kentaro
K
Tanigawa
Kazuyoshi
K
Nakaji
Shun
S
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods; D002311:Cardiomyopathy, Dilated / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function