title: [Surgical ventricular restoration for functional mitral regurgitation].
abstract: BACKGROUND
  This study evaluated the effectiveness and limitations of the surgical ventricular restoration(SVR)procedure in patients with functional mitral regurgitation(FMR)due to severe leaflet tethering.
  
  
  METHODS
  From 2008 to 2012, FMR was treated in 39 patients by either mitral annuloplasty(MAP)alone( group M:n=17) or MAP combined with SVR( group S:n=22). Preoperatively, patients in group S had lower ejection fraction( EF), larger left ventricle, and more severe mitral regurgiation( MR) comparing to group M.
  
  
  RESULTS
  The SVR performed in group S included posterior wall exclusion(Batista)in 10, septal-anteriorventricular exclusion in 8, overlapping ventriculoplasty in 2, and others in addition to papillary muscle approximation(PMA). Coronary revascularization was more common in the group M. Hospital mortality were 18% in group S and 0 in group M. There were no significant improvement on EF in both group, but left ventricular( LV) dimensions decreased significantly in both groups. Also, MR grade decreased significantly in both groups. Leaflet tethering was improved significantly in group S. There were 5 and 1 late deaths in group S and M, respectively.
  
  
  CONCLUSIONS
  SVR in addition to MAP yielded excellent reduction of leaflet tethering and MR in patients with severe LV dilatation. However, long-term outcomes were poor in those requiring SVR.
authors.affiliation: Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Funamoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Minakata
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Masahide
authors.initials: M
authors.lastname: Kawato
authors.forename: Syuji
authors.initials: S
authors.lastname: Setozaki
authors.forename: Takahide
authors.initials: T
authors.lastname: Takeda
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tsuneyoshi
authors.forename: Akira
authors.initials: A
authors.lastname: Marui
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Sakata
mesh_terms: D000368:Aged; D005260:Female; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000503:physiopathology / Q000601:surgery*; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000601:surgery