title: Mitral stenosis after IMR ETlogix ring annuloplasty for ischemic regurgitation.
abstract: OBJECTIVE
  Ring annuloplasty combined with coronary artery bypass grafting is the standard approach for treatment of patients with ischemic mitral regurgitation. We evaluated mitral valve hemodynamic performance and recurrence of mitral regurgitation after ring annuloplasty.
  
  
  METHODS
  40 consecutive patients (mean age, 70±8 years) with chronic ischemic mitral regurgitation grade ≥2+ received annuloplasty with an IMR ETlogix ring. During follow-up (25.9±15.5 months), 84% of surviving patients underwent exercise stress echocardiography to assess recurrence of mitral regurgitation and differences between rest and exercise mitral valve hemodynamic performance.
  
  
  RESULTS
  Hospital mortality was 10%. During follow-up, we found no significant differences between left ventricular ejection fraction or end-diastolic and end-systolic diameters pre- and postoperatively (41% vs. 45%, 59 vs. 56 mm, and 49 vs. 46 mm, respectively), but there was a significant increase in mitral mean gradient with exercise (3.3±1.2 vs. 7.8±4 mmHg, p<0.001). Two patients had mitral regurgitation ≥grade III-IV.
  
  
  CONCLUSIONS
  Mitral annuloplasty with the IMR ETlogix ring provides effective correction of chronic ischemic mitral regurgitation, but this technique may induce functional mitral stenosis.
authors.affiliation: Department of Cardiac Surgery, Hospital de León, León, Spain. carlosestebanmartin@hotmail.com
authors.forename: Carlos-Esteban
authors.initials: CE
authors.lastname: Martín
authors.forename: Mario
authors.initials: M
authors.lastname: Castaño
authors.forename: Jesús
authors.initials: J
authors.lastname: Gomez-Plana
authors.forename: Javier
authors.initials: J
authors.lastname: Gualis
authors.forename: Jose Manuel M
authors.initials: JM
authors.lastname: Comendador
authors.forename: Ignacio
authors.initials: I
authors.lastname: Iglesias
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D002908:Chronic Disease; D001026:Coronary Artery Bypass; D015150:Echocardiography, Doppler; D025401:Echocardiography, Stress; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects* / Q000295:instrumentation*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D011474:Prosthesis Design; D012008:Recurrence; D012189:Retrospective Studies; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left