PMID- 19411177
OWN - NLM
STAT- MEDLINE
DCOM- 20091019
LR  - 20191210
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 36
IP  - 2
DP  - 2009 Aug
TI  - Mid-term echocardiographic results with different rings following restrictive 
      mitral annuloplasty for ischaemic cardiomiopathy.
PG  - 250-60; discussion 260
LID - 10.1016/j.ejcts.2009.03.051 [doi]
AB  - BACKGROUND: Despite restrictive mitral annuloplasty (RMA) being considered 
      effective for chronic ischaemic mitral regurgitation (CIMR), few data exist on 
      mid-term echocardiographic results with different prosthetic rings. Therefore, 
      comparative echocardiographic analysis has been performed. METHODS: Sixty-four 
      consecutive coronary artery bypass graft surgery (CABG) + RMA (downsizing by 
      two-ring sizes; median size: 26 mm) for CIMR with a follow-up of at least 6 
      months were prospectively followed-up with serial echocardiograms (preoperative, 
      discharge, 6 months, follow-up ending). Hospital mortality, follow-up clinical 
      and echocardiographic results were analysed and compared between three groups 
      (group A: semi-rigid band, 17 patients; group B: complete symmetric semi-rigid, 
      22 patients; group C: complete asymmetric semi-rigid, 25 patients). RESULTS: 
      Hospital mortality was 6.3%; 22.8 +/- 14.7 standard deviation (SD) months (range: 
      6-55) survival was 96.5 +/- 2.5%; freedom from re-intervention was 94.2 +/- 4.2%, 
      from re-revascularisation 87.5 +/- 11.7%, from > or = grade-2 mitral 
      regurgitation 58.2 +/- 9.8% and from heart failure (CHF) 71.6 +/- 10.5%. 
      Recurrent (> or = grade-2) CIMR resulted in lower freedom-from-CHF (p = 0.0001), 
      worsened New York Heart Association (NYHA) classification (p = 0.0001) and 
      absence of reverse remodelling of the left ventricular end-diastolic diameter 
      (LVEDD; p = 0.004), systolic diameter (LVESD; p = 0.014), indexed mass (LVMi; p = 
      0.005) and coaptation depth (p = 0.0001). Group A showed significant worse 
      freedom from CHF (group A: 42.8 +/- 19.5% vs group B: 88.9 +/- 10.5% vs group C: 
      92.3 +/- 7.5%; p = 0.049) and from recurrent CIMR (17.4 +/- 13.8% vs 82.1 +/- 
      11.7% vs 94.1 +/- 5.7%, respectively; p = 0.0001). Complete rings decreased the 
      hazard of recurrent CIMR (Physio = 0.141; Adams = 0.089). Higher NYHA during 
      follow-up was found in group A (p = 0.002 for group B and p = 0.001 for group C) 
      with a progressive reduction of trans-mitral mean gradient (p = 0.001), and a 
      lower degree of reverse remodelling of LVEDD (p = 0.009 and p = 0.010) and 
      coaptation depth (p = 0.040 and p = 0.002). CONCLUSIONS: Recurrent CIMR 
      correlates with absent ventricular reverse remodelling. Despite a higher 
      trans-mitral gradient, complete rings achieve better results in the treatment of 
      CIMR.
FAU - Onorati, Francesco
AU  - Onorati F
AD  - Cardiac Surgery Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy. 
      frankono@libero.it
FAU - Rubino, Antonino Salvatore
AU  - Rubino AS
FAU - Marturano, Domenico
AU  - Marturano D
FAU - Pasceri, Eugenia
AU  - Pasceri E
FAU - Mascaro, Giuseppina
AU  - Mascaro G
FAU - Zinzi, Stefania
AU  - Zinzi S
FAU - Serraino, Filiberto
AU  - Serraino F
FAU - Renzulli, Attilio
AU  - Renzulli A
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20090502
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Aged
MH  - Coronary Artery Bypass
MH  - Epidemiologic Methods
MH  - Female
MH  - Heart Valve Prosthesis Implantation/*methods
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/diagnostic imaging/*surgery
MH  - Mitral Valve Insufficiency/diagnostic imaging/physiopathology/*surgery
MH  - Myocardial Ischemia/diagnostic imaging/physiopathology/*surgery
MH  - Recurrence
MH  - Treatment Outcome
MH  - Ultrasonography
MH  - Ventricular Remodeling
EDAT- 2009/05/05 09:00
MHDA- 2009/10/20 06:00
CRDT- 2009/05/05 09:00
PHST- 2008/08/26 00:00 [received]
PHST- 2009/02/26 00:00 [revised]
PHST- 2009/03/03 00:00 [accepted]
PHST- 2009/05/05 09:00 [entrez]
PHST- 2009/05/05 09:00 [pubmed]
PHST- 2009/10/20 06:00 [medline]
AID - S1010-7940(09)00249-8 [pii]
AID - 10.1016/j.ejcts.2009.03.051 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2009 Aug;36(2):250-60; discussion 260. doi: 
      10.1016/j.ejcts.2009.03.051. Epub 2009 May 2.