PMID- 23882872
OWN - NLM
STAT- MEDLINE
DCOM- 20130813
LR  - 20191112
IS  - 0001-5385 (Print)
IS  - 0001-5385 (Linking)
VI  - 68
IP  - 3
DP  - 2013 Jun
TI  - Efficacy of papillary muscle approximation in preventing functional mitral 
      regurgitation recurrence in high-risk patients with ischaemic cardiomyopathy and 
      mitral regurgitation.
PG  - 271-8
AB  - BACKGROUND: Dilated cardiomyopathy (DCM) is often complicated by the appearance 
      of functional mitral regurgitation (FMR). Although mitral ring annuloplasty (MAP) 
      is the most widely used surgical procedure for the surgical treatment of FMR, 
      there are still reports of patients who suffer recurrent FMR at later follow-ups. 
      We sought to investigate the efficacy of papillary muscle approximation (PMA) 
      combined with MAP in preventing the recurrence of FMR in high-risk patients. 
      METHODS: One hundred patients with ischaemic (74%) or non-ischaemic (26%) DCM 
      along with severe (4+/4+) or moderately severe (3+/4+) FMR were enrolled in this 
      prospective, cross-sectional study. According to the interpapillary muscle 
      distance (iPMD) and coaptation depth (CD), the patients were risk stratified as 
      low (iPMD + CD 30 mm, n= 69) and high-risk (iPMD + CD > 30 mm, n= 31) groups. The 
      low-risk patients underwent only MAP, whereas the high-risk patients underwent 
      MAP plus PMA. RESULTS: After a mean +/- SD follow-up of 40.8 +/- 12.5 months, 
      recurrence of 3+ to 4+ MR was observed in 8 (8.7%) and 7 (11.1%) patients in the 
      annuloplasty group (MAP-only) and one (3.4%) patient in the combination group 
      (MAP plus PMA) (P= 0.428). At the final follow-up, the New York Heart Association 
      (NYHA) function class was 1.57 +/- 0.62 in the annuloplasty group and 1.45 +/- 
      0.57 in the combination group; there was no significant difference in NYHA 
      function class between the first and final follow-ups (P> 0.05). CONCLUSION: iPMD 
      is a valuable index in the riskstratification of the recurrence of post-MAP MR in 
      patients with DCM complicated by FMR.The patients treated with MAP plus PMA had 
      more favourable outcomes and lower recurrence rates than those treated via the 
      traditional route of MAP only.
FAU - Roshanali, Farideh
AU  - Roshanali F
AD  - Department of Cardiology, Day General Hospital, Tehran, Iran.
FAU - Vedadian, Ali
AU  - Vedadian A
FAU - Shoar, Saeed
AU  - Shoar S
FAU - Naderan, Mohammad
AU  - Naderan M
FAU - Mandegar, Mohammad Hossein
AU  - Mandegar MH
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - England
TA  - Acta Cardiol
JT  - Acta cardiologica
JID - 0370570
SB  - IM
MH  - Cardiac Surgical Procedures/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Incidence
MH  - Iran/epidemiology
MH  - Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/complications/physiopathology/*surgery
MH  - Myocardial Ischemia/epidemiology/etiology/*prevention & control
MH  - Papillary Muscles/diagnostic imaging/pathology/*surgery
MH  - Prospective Studies
MH  - Risk Factors
MH  - Secondary Prevention
MH  - Ultrasonography
MH  - *Ventricular Function, Left
EDAT- 2013/07/26 06:00
MHDA- 2013/08/14 06:00
CRDT- 2013/07/26 06:00
PHST- 2013/07/26 06:00 [entrez]
PHST- 2013/07/26 06:00 [pubmed]
PHST- 2013/08/14 06:00 [medline]
AID - 10.1080/ac.68.3.2983421 [doi]
PST - ppublish
SO  - Acta Cardiol. 2013 Jun;68(3):271-8. doi: 10.1080/ac.68.3.2983421.