PMID- 18615371
OWN - NLM
STAT- MEDLINE
DCOM- 20081212
LR  - 20080710
IS  - 0171-6425 (Print)
IS  - 0171-6425 (Linking)
VI  - 56
IP  - 5
DP  - 2008 Aug
TI  - Early and late results of restrictive mitral valve annuloplasty in 121 patients 
      with cardiomyopathy and chronic mitral regurgitation.
PG  - 262-8
LID - 10.1055/s-2008-1038420 [doi]
AB  - OBJECTIVE: This study investigated the early and late results of restrictive 
      mitral valve (MV) annuloplasty in patients with chronic mitral regurgitation (MR) 
      and advanced ischemic (ICM) or dilated cardiomyopathy (DCM). METHODS: From 
      October 2001 to September 2006, 121 patients (age: 69 +/- 9 years) with a left 
      ventricular ejection fraction (LVEF) of 30 +/- 9 % and chronic MR grade 3 - 4 
      (ICM: n = 102, DCM: n = 19) underwent restrictive prosthetic ring annuloplasty 
      (downsizing of 2.7 +/- 0.8 ring sizes). Eighty-five ICM-patients had indications 
      for concomitant coronary artery bypass grafting (CABG). All patients were 
      restudied at 7 +/- 1 days, 3 +/- 1 and 30 +/- 12 months after surgery to assess 
      survival, residual MR, New York Heart Association (NYHA) class and left 
      ventricular (LV) function (end-systolic/end-diastolic dimensions/volume indexes 
      and LVEF). Data were analyzed exploratively. RESULTS: 30-day mortality was 3.3 %; 
      survival at follow-up was 95 % and 91 %, respectively. Postoperative recurrence 
      of significant MR (> grade 2) was absent in all patients. NYHA class, LV 
      dimensions/volume indexes and LVEF improved significantly after surgery in both 
      groups ( P < 0.0005). A prediction of continuous postoperative improvement of 
      myocardial function in the sense of reverse remodeling could be demonstrated by 
      univariate logistic regression for ischemic etiology and concomitant CABG ( P = 
      0.0001). In DCM-patients or ICM-patients without CABG, the postoperative benefit 
      on myocardial function was limited. CONCLUSION: Restrictive mitral valve (MV) 
      annuloplasty corrected chronic MR in cardiomyopathy patients with low mortality 
      and improved contractility. Surgery also prevented recurrence of significant MR, 
      although the phenomenon of postoperative continuous reverse myocardial remodeling 
      could not be verified in cases with a non-ischemic etiology or ICM without 
      concomitant CABG.
FAU - Geidel, S
AU  - Geidel S
AD  - Abteilung fur Herzchirurgie, Asklepios Klinik St. Georg, Lohmuhlenstrasse 5, 
      Hamburg, Germany. stgeidel@aol.com
FAU - Lass, M
AU  - Lass M
FAU - Krause, K
AU  - Krause K
FAU - Schneider, C
AU  - Schneider C
FAU - Boczor, S
AU  - Boczor S
FAU - Kuck, K-H
AU  - Kuck KH
FAU - Ostermeyer, J
AU  - Ostermeyer J
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Thorac Cardiovasc Surg
JT  - The Thoracic and cardiovascular surgeon
JID - 7903387
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiomyopathies/complications/mortality/physiopathology/*surgery
MH  - Chronic Disease
MH  - *Coronary Artery Bypass
MH  - Female
MH  - Heart Valve Prosthesis
MH  - *Heart Valve Prosthesis Implantation/instrumentation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/complications/mortality/physiopathology/*surgery
MH  - Myocardial Contraction
MH  - Prospective Studies
MH  - Prosthesis Design
MH  - Recurrence
MH  - Stroke Volume
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Function, Left
MH  - Ventricular Remodeling
EDAT- 2008/07/11 09:00
MHDA- 2008/12/17 09:00
CRDT- 2008/07/11 09:00
PHST- 2008/07/11 09:00 [pubmed]
PHST- 2008/12/17 09:00 [medline]
PHST- 2008/07/11 09:00 [entrez]
AID - 10.1055/s-2008-1038420 [doi]
PST - ppublish
SO  - Thorac Cardiovasc Surg. 2008 Aug;56(5):262-8. doi: 10.1055/s-2008-1038420.