PMID- 12808479
OWN - NLM
STAT- MEDLINE
DCOM- 20031118
LR  - 20071115
IS  - 1470-8590 (Print)
IS  - 1470-8590 (Linking)
VI  - 4
IP  - 1
DP  - 2003
TI  - Mitral valve repair as an alternative treatment for heart failure patients.
PG  - 7-12
AB  - Heart failure is one of the leading causes of hospitalization worldwide. Mitral 
      regurgitation (MR) is a known complication of end-stage cardiomyopathy and is 
      associated with a poor prognosis. Historically, these patients were managed 
      medically and frequently with mitral valve replacement, both of which have 
      unfavorable long-term outcomes. Over a 10-year period, we studied 167 patients 
      with cardiomyopathy and severe MR who underwent mitral valve repair. These 
      patients with 4+ MR, a mean left ventricular ejection fraction (LVEF) of 14+/-6 
      and New York Heart Association (NYHA) class III or IV congestive heart failure 
      (CHF) were prospectively studied. All patients underwent mitral valve repair with 
      an undersized annuloplasty ring. There was one intra-operative death and eight 
      30-day mortalities. Intra-operative echocardiography revealed no MR in most 
      patients and trivial to mild MR in seven patients. There were 26 late deaths; two 
      of these patients had progression of CHF and underwent transplantation. The 1-, 
      2-, and 5-year actuarial survival rates were 82%, 71%, and 52%, respectively. 
      NYHA class was improved for all patients from a pre-operative mean of 3.2+/-0.2 
      to 1.8+/-0.4 postoperatively. At 24-month follow-up, all patients demonstrated 
      improvement in LVEF, cardiac output, and end-diastolic volume, with a reduction 
      in sphericity index and regurgitant volume. Mitral valve repair utilizing an 
      undersized annuloplasty ring is safe and effectively corrects MR in 
      cardiomyopathic patients. All of the observed changes contribute to reverse 
      remodeling and restoration of the normal LV geometric relationship. Mitral valve 
      repair offers a new strategy for patients with MR and end-stage cardiomyopathy.
FAU - Romano, Matthew A
AU  - Romano MA
AD  - Section of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.
FAU - Bolling, Steven F
AU  - Bolling SF
LA  - eng
PT  - Journal Article
PL  - England
TA  - Heart Fail Monit
JT  - Heart failure monitor
JID - 101140283
SB  - IM
MH  - Follow-Up Studies
MH  - Heart Failure/*complications/mortality/surgery
MH  - Humans
MH  - Mitral Valve/*surgery
MH  - Mitral Valve Insufficiency/complications/mortality/*surgery
MH  - Prospective Studies
MH  - Prostheses and Implants
MH  - Survival Rate
MH  - Time Factors
EDAT- 2003/06/17 05:00
MHDA- 2003/12/03 05:00
CRDT- 2003/06/17 05:00
PHST- 2003/06/17 05:00 [pubmed]
PHST- 2003/12/03 05:00 [medline]
PHST- 2003/06/17 05:00 [entrez]
PST - ppublish
SO  - Heart Fail Monit. 2003;4(1):7-12.