title: Ischemic mitral regurgitation: mechanisms, intraoperative echocardiographic evaluation, and surgical considerations.
abstract: Ischemic mitral regurgitation (IMR) is a subcategory of functional rather than organic, mitral valve (MV) disease. Whether reversible or permanent, left ventricular remodeling creates IMR that is complex and multifactorial. A comprehensive TEE examination in patients with IMR may have important implications for perioperative clinical decision making. Several TEE measures predictive of MV repair failure have been identified. Current practice among most surgeons is to typically repair the MV in patients with IMR. MV replacement is usually reserved for situations in which the valve cannot be reasonably repaired, or repair is unlikely to be tolerated clinically.
authors.affiliation: Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Connell
authors.forename: Andrea
authors.initials: A
authors.lastname: Worthington
authors.forename: Frederick Y
authors.initials: FY
authors.lastname: Chen
authors.forename: Stanton K
authors.initials: SK
authors.lastname: Shernan
mesh_terms: D017548:Echocardiography, Transesophageal; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016343:Monitoring, Intraoperative; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*