PMID- 16030474
OWN - NLM
STAT- MEDLINE
DCOM- 20051007
LR  - 20050720
IS  - 1341-1098 (Print)
IS  - 1341-1098 (Linking)
VI  - 11
IP  - 3
DP  - 2005 Jun
TI  - Late development of mitral regurgitation after left ventricular reconstruction 
      surgery.
PG  - 159-63
AB  - PURPOSE: Late presence of mitral regurgitation (MR) after the Dor procedure (left 
      ventricular (LV) reconstruction associated with coronary artery bypass grafting) 
      for postinfarction patients carries a poor prognosis. The aim of this study was 
      to review our experience with the Dor procedure and to analyze the correlation of 
      surgical results with late MR. METHODS: The study group comprised 19 patients 
      with previous anterior transmural myocardial infarction (MI). Ten patients were 
      classified as New York Heart Association (NYHA) functional class III or IV at 
      surgery. MR was moderate in 2 patients and mild in 15 patients. RESULTS: 
      Myocardial revascularization was performed in all patients, with a mean of 
      3.7+/-1.2 grafts. Mitral valve was repaired in 6 patients. Four patients with 
      mild MR underwent posterior annuloplasty, and 2 with moderate MR underwent rigid 
      annular remodeling. Early postoperative NYHA functional class improved from 
      2.7+/-0.9 to 1.3+/-0.5; however, MR deteriorated to moderate in 5 patients with 
      worsening NYHA functional class 3 months after surgery. Although the valve was 
      not repaired during surgery in 4 patients with preoperative mild MR, 1 patient 
      with moderate MR underwent annuloplasty with a rigid ring. All patients with late 
      MR underwent more than 30-mL/m2 reduction of end-diastolic volume index at 
      surgery. Cumulative 4-year survival including hospital deaths was 89.5%. 
      CONCLUSION: To prevent the risk of late MR, a more than 30-mL/m2 reduction of 
      end-diastolic volume index should be avoided and mitral valve repair should be 
      performed even if preoperative functional MR is only mild.
FAU - Yotsumoto, Goichi
AU  - Yotsumoto G
AD  - Second Department of Surgery, Kagoshima University, Kagoshima, Japan.
FAU - Sakata, Ryuzo
AU  - Sakata R
FAU - Ueno, Takayuki
AU  - Ueno T
FAU - Iguro, Yoshifumi
AU  - Iguro Y
FAU - Kinjo, Tamahiro
AU  - Kinjo T
FAU - Kobayashi, Akira
AU  - Kobayashi A
FAU - Matsumoto, Kazuhisa
AU  - Matsumoto K
FAU - Tei, Chuwa
AU  - Tei C
FAU - Otsuji, Yutaka
AU  - Otsuji Y
FAU - Tanaka, Yasuhiro
AU  - Tanaka Y
LA  - eng
PT  - Journal Article
PL  - Japan
TA  - Ann Thorac Cardiovasc Surg
JT  - Annals of thoracic and cardiovascular surgery : official journal of the 
      Association of Thoracic and Cardiovascular Surgeons of Asia
JID - 9703158
SB  - IM
MH  - Aged
MH  - Cardiopulmonary Bypass
MH  - Female
MH  - Heart Ventricles/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/*etiology
MH  - Myocardial Infarction/*surgery
MH  - Retrospective Studies
MH  - Ventricular Dysfunction, Left/*surgery
EDAT- 2005/07/21 09:00
MHDA- 2005/10/08 09:00
CRDT- 2005/07/21 09:00
PHST- 2005/07/21 09:00 [pubmed]
PHST- 2005/10/08 09:00 [medline]
PHST- 2005/07/21 09:00 [entrez]
PST - ppublish
SO  - Ann Thorac Cardiovasc Surg. 2005 Jun;11(3):159-63.