Evaluation of left ventricular diastolic function after edge-to-edge mitral valve plasty.
BACKGROUND
Edge-to-edge mitral valve plasty technique has been widely used to treat bileaflet prolapse. This procedure anchors the correspondence leaflets to create a double-orifice mitral valve. The original mitral valve anatomy is changed, and the opening of mitral valve is restricted. Little is known whether this procedure affects the left ventricular diastolic function.


METHODS
Thirty patients with mitral regurgitation were included in this study. Fifteen with posterior leaflet prolapse received quadrangular resection (group 1), 15 with anterior or bileaflet prolapse underwent edge-to-edge procedure (group 2). Acute hemodynamics was monitored with a Swan-Ganz catheter (Edwards Lifesciences LLC, Irvine, CA, USA). Left ventricular diastolic function was also evaluated with echocardiography in 28 patients with sinus rhythm. The ratio of peak E velocity and A velocity (E/A), the ratio of early diastolic peak flow velocity to early diastolic mitral annular movement velocity (E/Em), and the ratio of early diastolic mitral annular velocity to late diastolic mitral annular velocity (Em/Am) were measured before operation and one week after operation.


RESULTS
Mitral valve area and mitral regurgitate grade decreased significantly after operation. There was no significant change in pulmonary artery wedge pressure between two groups and in each group before and after operation. Echocardiography evaluation showed there was no significant difference in E/A, E/Em, and Em/Am before and after operation between two groups and in each group.


CONCLUSIONS
Edge-to-edge mitral valve plasty procedure has no significant impairment on left ventricular diastolic function. A double-orifice mitral valve has similar hemodynamic behavior with a physiological valve.
Lai
Yong-Qiang
YQ
Division of Cardiac Surgery, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing, China. yongqianglai@yahoo.com
Bai
Tao
T
Li
Jin-Hua
JH
Wang
Jiong
J
Liu
Xiao-Ming
XM
Meng
Xu
X
Zhang
Zhao-Guang
ZG
D000328:Adult; D000368:Aged; D002407:Catheterization, Swan-Ganz; D003971:Diastole; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D014463:Ultrasonography; D016277:Ventricular Function, Left