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Predicting functional mitral stenosis after restrictive annuloplasty for ischemic mitral regurgitation
Affiliations- State Key Laboratory of Cardiovascular Disease, Department of Adult Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
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Abstract
Background: Although it has been realized that restrictive mitral valve annuloplasty (MVA) may result in clinically significant functional mitral stenosis (MS), it still cannot be predicted. The purpose of this study was to identify risk factors for clinically significant functional MS following restrictive MVA surgery for chronic ischemic mitral regurgitation (CIMR).
Methods: One hundred and fourteen patients who underwent restrictive MVA with coronary artery bypass grafting (CABG) for treatment of CIMR were retrospectively reviewed. Clinically significant functional MS was defined as resting transmitral peak pressure gradient (PPG) ≥ 13 mmHg.
Results: During the follow-up period (range 6–12 months), 28 (24.56%) patients developed clinically significant functional MS. The PPG at follow-up was significantly higher than that measured in the early postoperative stage (3–5 days after surgery). Moreover, there was a linear correlation between the two measurements (r = 0.398, p < 0.001). Annuloplasty size ≤ 27 mm and early postoperative PPG ≥ 7.4 mmHg could predict clinically significant functional MS at 6–12 months postoperatively.
Conclusions: Chronic ischemic mitral regurgitation patients treated with restrictive MVA and CABG have significant increases in PPG postoperatively. Annuloplasty size ≤ 27 mm and early postoperative PPG ≥ 7.4 mmHg can predict clinically significant functional MS at 6–12 months after surgery.
Abstract
Background: Although it has been realized that restrictive mitral valve annuloplasty (MVA) may result in clinically significant functional mitral stenosis (MS), it still cannot be predicted. The purpose of this study was to identify risk factors for clinically significant functional MS following restrictive MVA surgery for chronic ischemic mitral regurgitation (CIMR).
Methods: One hundred and fourteen patients who underwent restrictive MVA with coronary artery bypass grafting (CABG) for treatment of CIMR were retrospectively reviewed. Clinically significant functional MS was defined as resting transmitral peak pressure gradient (PPG) ≥ 13 mmHg.
Results: During the follow-up period (range 6–12 months), 28 (24.56%) patients developed clinically significant functional MS. The PPG at follow-up was significantly higher than that measured in the early postoperative stage (3–5 days after surgery). Moreover, there was a linear correlation between the two measurements (r = 0.398, p < 0.001). Annuloplasty size ≤ 27 mm and early postoperative PPG ≥ 7.4 mmHg could predict clinically significant functional MS at 6–12 months postoperatively.
Conclusions: Chronic ischemic mitral regurgitation patients treated with restrictive MVA and CABG have significant increases in PPG postoperatively. Annuloplasty size ≤ 27 mm and early postoperative PPG ≥ 7.4 mmHg can predict clinically significant functional MS at 6–12 months after surgery.
Keywords
chronic ischemic mitral regurgitation; restrictive mitral valve annuloplasty; coronary artery bypass grafting; functional mitral stenosis; transmitral peak pressure gradient
About this articleTitle
Predicting functional mitral stenosis after restrictive annuloplasty for ischemic mitral regurgitation
Journal
Issue
Pages
350-359
Published online
2018-03-02
Page views
3319
Article views/downloads
1199
DOI
10.5603/CJ.a2018.0023
Pubmed
Bibliographic record
Cardiol J 2019;26(4):350-359.
Keywords
chronic ischemic mitral regurgitation
restrictive mitral valve annuloplasty
coronary artery bypass grafting
functional mitral stenosis
transmitral peak pressure gradient
Authors
Baotong Li
Hengchao Wu
Hansong Sun
Jianping Xu
Yunhu Song
Wei Wang
Shuiyun Wang
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