title: Long-term echocardiographic follow-up after posterior mitral annuloplasty using a vascular strip for ischemic mitral regurgitation: ten-years of experience at a single center.
abstract: Management of ischemic mitral regurgitation (MR) is challenging. The aim of this study was to investigate long-term clinical and echocardiographic results of restrictive mitral annuloplasty for ischemic MR. From 2001 through 2010, 96 patients who underwent myocardial revascularization with restrictive mitral annuloplasty using a vascular strip for ischemic MR were analyzed. Patients were stratified into two groups based on left ventricular ejection fraction (LVEF): group I, n = 50, with LVEF > 35% and group II, n = 46, with LVEF ≤ 35%. The early mortality rate was 2.1% (2/96) and the late cardiac mortality rate was 11.5% (11/96). MR grade was reduced at discharge (0.8 ± 0.7) but increased during follow-up (1.1 ± 0.8, P = 0.001). There was no intergroup difference in terms of freedom from recurrent MR ≥ moderate eight years after surgery (94.1% ± 5.7%, group I vs 87.8% ± 7.2%, group II; P = 0.575). NYHA functional class (odds ratio [OR], 2.2; P = 0.044) and early postoperative residual MR ≥ mild (OR, 25.4; P < 0.001) were independent predictors of recurrent MR. Restrictive mitral annuloplasty using a vascular strip is effective in ischemic MR. It is important to avoid early postoperative residual MR.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Dong Seop
authors.initials: DS
authors.lastname: Jeong
authors.forename: Hae Young
authors.initials: HY
authors.lastname: Lee
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Kim
authors.forename: Kiick
authors.initials: K
authors.lastname: Sung
authors.forename: Tae-Gook
authors.initials: TG
authors.lastname: Jun
authors.forename: Ji-Hyuk
authors.initials: JH
authors.lastname: Yang
authors.forename: Pyo Won
authors.initials: PW
authors.lastname: Park
authors.forename: Young Tak
authors.initials: YT
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000379:methods*; D008944:Mitral Valve Insufficiency / Q000401:mortality / Q000601:surgery*; D017202:Myocardial Ischemia / Q000401:mortality / Q000601:surgery*; D009204:Myocardial Revascularization; D013318:Stroke Volume; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures