open access

Vol 26, No 4 (2019)
Original articles — Clinical cardiology
Published online: 2018-03-02
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Predicting functional mitral stenosis after restrictive annuloplasty for ischemic mitral regurgitation

Baotong Li, Hengchao Wu, Hansong Sun, Jianping Xu, Yunhu Song, Wei Wang, Shuiyun Wang
DOI: 10.5603/CJ.a2018.0023
·
Pubmed: 29512090
·
Cardiol J 2019;26(4):350-359.

open access

Vol 26, No 4 (2019)
Original articles — Clinical cardiology
Published online: 2018-03-02

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.

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Keywords

chronic ischemic mitral regurgitation; restrictive mitral valve annuloplasty; coronary artery bypass grafting; functional mitral stenosis; transmitral peak pressure gradient

About this article
Title

Predicting functional mitral stenosis after restrictive annuloplasty for ischemic mitral regurgitation

Journal

Cardiology Journal

Issue

Vol 26, No 4 (2019)

Pages

350-359

Published online

2018-03-02

DOI

10.5603/CJ.a2018.0023

Pubmed

29512090

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

References (16)
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