title: Mitral valve repair for atrial functional mitral regurgitation in patients with chronic atrial fibrillation.
abstract: OBJECTIVE
  Atrial functional mitral regurgitation (MR) has been recently described in patients with chronic atrial fibrillation (AF). However, the results of surgical mitral valve (MV) repair for this type of MR have not been comprehensively reported. Our study aimed to address this deficiency.
  
  
  METHODS
  We retrospectively studied 10 chronic AF patients who underwent MV repair for atrial functional MR with normal left ventricular dimension and preserved left ventricular systolic function. All patients had chronic heart failure (HF) symptoms and at least one prior admission for HF complicated by severe MR.
  
  
  RESULTS
  Ring annuloplasty was performed in all patients; the median ring size was 26 mm (range, 26-30 mm). Concomitant tricuspid valve repair was undertaken in all patients. Preoperatively, left atrial (LA) diameter on the parasternal long-axis view, LA volume index and mitral annular diameter were 52 ± 9 mm, 72 ± 26 ml/m(2) and 33 ± 4 mm, respectively. There was no mortality and no re-admission due to HF during follow-up (range, 10-52 months). MR at the most recent examination was mild or improved in degree in all patients. The LA volume index decreased from the preoperative period, measuring 48 ± 17 ml/m(2) at the most recent period (P = 0.03). The New York Heart Association functional class dramatically improved from the preoperative period to the most recent period (from 3.0 ± 0.7 to 1.2 ± 0.4, P < 0.0001).
  
  
  CONCLUSIONS
  Our results suggest that MV repair leads to reductions in MR, LA size and HF symptoms, and that it may prevent future HF events in patients with atrial functional MR.
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan ysk@msic.med.osaka-cu.ac.jp.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Cardiology, Osaka City General Hospital, Osaka, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Sasaki
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Bito
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: Akimasa
authors.initials: A
authors.lastname: Morisaki
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nishimura
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Shibata
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies
keywords: Atrial fibrillation; Atrium; Mitral regurgitation