PMID- 19880421
OWN - NLM
STAT- MEDLINE
DCOM- 20100128
LR  - 20101118
IS  - 1569-9285 (Electronic)
IS  - 1569-9285 (Linking)
VI  - 10
IP  - 1
DP  - 2010 Jan
TI  - Measured posterior annuloplasty for repair of non-ischemic mitral regurgitation. 
      A single unit follow-up.
PG  - 81-5
LID - 10.1510/icvts.2009.215798 [doi]
AB  - The aim of this report is to evaluate short- and long-term outcomes of 
      annuloplasty method of our choice: measured posterior annuloplasty (MPA). MPA is 
      a piece of a Duran ring cut to the length of free-edge of anterior mitral leaflet 
      (AML) and anchored with multiple pledgeted U-sutures from trigone to trigone into 
      the posterior annulus. MATERIAL AND METHODS: From 1988 to 2000, 103 consecutive 
      patients with non-ischemic mitral regurgitation were scheduled preoperatively to 
      be repaired by MPA. RESULTS: Preoperative mitral valve regurgitation (MR) grade 
      was 3.8+/-0.5 and decreased to 0.1+/-0.3 (P<0.0001) after repair. One patient was 
      converted to insertion of mechanical prosthesis after grade 3 MR persisted after 
      septal myectomy and MPA. Three patients needed instant revision of the repair one 
      due to SAM and two due to stenosis. No patient had a stenosis or unacceptable 
      (>1) MR after the procedure. There was one operative death (1.0%) and 3 
      hospital/30-day deaths (2.9%). Sixteen patients (16.3%) expired during the 
      follow-up to 91 months (mean 57.4+/-19.5, median 60 months) none due to failure 
      of MPA. There were no reoperations due to failure of MPA. Three patients had a 
      reoperation, one for dehiscence of reconstruction after P2 resection and two 
      patients due to progression of anterior leaflet degeneration and calcification 
      with 4+ MR. New York Heart Association (NYHA) functional classification decreased 
      from 2.3+/-0.8 to 1.4+/-0.6 (P<0.0001) and only one patient had an increase from 
      II to III. Eighty-eight patients (96.7%) were in NYHA class I-II. Ten patients 
      had an increase of MR from 0 to trace or 1 and one from 0 to 2. Two patients were 
      diagnosed with mild stenosis without need of reoperation. CONCLUSIONS: MPA is a 
      durable and stable alternative for repair of non-ischemic mitral regurgitation of 
      different etiologies. The technique gives an objective measure of the length of 
      the band and no patient is left with a significant MR or mitral valve stenosis 
      (MS). First-time success rate is very high and instant repairs few and minor. 
      Freedom of MPA related reoperations is 100%.
FAU - Jyrala, Aarne
AU  - Jyrala A
AD  - Department of Cardiothoracic Surgery, Heart Institute, Good Samaritan Hospital, 
      Los Angeles, CA, USA. lathoracic@hotmail.com
FAU - Gatto, Nicole M
AU  - Gatto NM
FAU - Kay, Gregory L
AU  - Kay GL
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20091030
PL  - England
TA  - Interact Cardiovasc Thorac Surg
JT  - Interactive cardiovascular and thoracic surgery
JID - 101158399
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/adverse 
      effects/instrumentation/*methods/mortality
MH  - Hospital Mortality
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/etiology/mortality/*surgery
MH  - Prosthesis Design
MH  - Reoperation
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Suture Techniques
MH  - Time Factors
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2009/11/03 06:00
MHDA- 2010/01/29 06:00
CRDT- 2009/11/03 06:00
PHST- 2009/11/03 06:00 [entrez]
PHST- 2009/11/03 06:00 [pubmed]
PHST- 2010/01/29 06:00 [medline]
AID - icvts.2009.215798 [pii]
AID - 10.1510/icvts.2009.215798 [doi]
PST - ppublish
SO  - Interact Cardiovasc Thorac Surg. 2010 Jan;10(1):81-5. doi: 
      10.1510/icvts.2009.215798. Epub 2009 Oct 30.