PMID- 25740449
OWN - NLM
STAT- MEDLINE
DCOM- 20160608
LR  - 20181113
IS  - 2186-1005 (Electronic)
IS  - 1341-1098 (Print)
IS  - 1341-1098 (Linking)
VI  - 21
IP  - 4
DP  - 2015
TI  - Surgical strategy for ischemic mitral regurgitation adopting subvalvular and 
      ventricular procedures.
PG  - 370-7
LID - 10.5761/atcs.oa.14-00204 [doi]
AB  - PURPOSE: The progression of left ventricular (LV) remodeling and subsequent 
      mitral valve tethering impair the results of reduction annuloplasty for ischemic 
      mitral regurgitation (MR). METHODS: We studied 90 patients who underwent surgical 
      repair of ischemic MR between 1999 and 2013 according to our surgical strategy 
      adding submitral and ventricular procedures to annuloplasty as follows: 
      annuloplasty alone (stage 1, n = 30), additional papillary muscle approximation 
      (PMA) for progression of tethering (stage 2, n = 26), and additional left 
      ventriculoplasty with PMA for progression of LV remodeling and tethering (stage 
      3, n = 34). RESULTS: The preoperative New York Heart Association (NYHA) 
      functional classes (2.5 +/- 0.7, 3.1 +/- 0.7 and 3.3 +/- 0.7 for stages 1, 2 and 3, 
      respectively, P <0.001), LV end-diastolic diameters (56 +/- 7 mm, 66 +/- 5 mm and 70 
      +/- 7 mm, P <0.001), and LV ejection fractions (45 +/- 12%, 32 +/- 9% and 27 +/- 9%, P 
      <0.001) significantly differed among the stages. In contrast, the MR grades did 
      not significantly differ (2.9 +/- 0.8, 3.0 +/- 1.0, and 2.9 +/- 1.1, respectively; P = 
      0.93). Both the rates of cardiac-related survival and freedom from reoperation 
      were comparable among the 3 groups (log-rank P = 0.92 and 0.58, respectively). 
      CONCLUSION: Additional submitral and ventricular procedures can compensate for 
      the possible impairment of the outcomes after annuloplasty alone for ischemic MR 
      in patients with severe LV remodeling and tethering.
FAU - Wakasa, Satoru
AU  - Wakasa S
AD  - Department of Cardiovascular and Thoracic Surgery, Hokkaido University Graduate 
      School of Medicine, Sapporo, Hokkaido, Japan.
FAU - Shingu, Yasushige
AU  - Shingu Y
FAU - Ooka, Tomonori
AU  - Ooka T
FAU - Katoh, Hiroki
AU  - Katoh H
FAU - Tachibana, Tsuyoshi
AU  - Tachibana T
FAU - Matsui, Yoshiro
AU  - Matsui Y
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20150216
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
EIN - Ann Thorac Cardiovasc Surg. 2016;22(2):125. PMID: 27098646
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiomyopathies/complications
MH  - Coronary Artery Disease/complications
MH  - Female
MH  - Follow-Up Studies
MH  - *Heart Valve Prosthesis Implantation/methods
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - *Mitral Valve Annuloplasty/methods
MH  - Mitral Valve Insufficiency/diagnosis/etiology/mortality/*surgery
MH  - Papillary Muscles/surgery
MH  - Postoperative Care
MH  - Preoperative Care
MH  - Recurrence
MH  - Reoperation
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC4904874
EDAT- 2015/03/06 06:00
MHDA- 2016/06/09 06:00
PMCR- 2015/01/01
CRDT- 2015/03/06 06:00
PHST- 2015/03/06 06:00 [entrez]
PHST- 2015/03/06 06:00 [pubmed]
PHST- 2016/06/09 06:00 [medline]
PHST- 2015/01/01 00:00 [pmc-release]
AID - atcs.oa.14-00204 [pii]
AID - 10.5761/atcs.oa.14-00204 [doi]
PST - ppublish
SO  - Ann Thorac Cardiovasc Surg. 2015;21(4):370-7. doi: 10.5761/atcs.oa.14-00204. Epub 
      2015 Feb 16.