Browse > Article

Mitral Valve Reconstruction in Patients with Moderate to Severe Left Ventricular Dysfunction  

Baek, Man-Jong (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Bucheon)
Na, Chan-Young (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Bucheon)
Oh, Sam-Sae (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Bucheon)
Kim, Woong-Han (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Bucheon)
Whang, Sung-Wook (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Bucheon)
Kim, Soo-Cheol (Dept. of Thoracic and Cardiovascular Surgery, College of Medicine, Kyunghee University)
Lim, Cheong (Dept. of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University)
Kim, Wook-Sung (Dept. of Thoracic and Cardiovascular Surgery, Ilsan Paik Hospital, Inje University)
Lee, Young-Tak (Dept. of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Kim, Chong-Whan (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Bucheon)
Publication Information
Journal of Chest Surgery / v.36, no.11, 2003 , pp. 812-819 More about this Journal
Abstract
Background: Left ventricular dysfunction is one of the important prognostic factors of early mortality and long-term survival after valve operation. We studied the intermediate term results of mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction. Material and Method: Forty four patients who underwent mitral valve reconstruction with a left ventricular ejection fraction (EF) of <45% or less (20∼45%) from April 1995 through July 2001 were reviewed retrospectively. Ages ranged from 10 to 67 years (46∼14 years) and 32 patients were in NYHA class III-IV. The mitral valve diseases were regurgitation (MR) in 28 patients, stenosis(MS) in 10, and mixed lesion in 5. The etiologies of mitral valve disease were rheumatic in 20 patients, degenerative in 14, ischemic in 5, annular dilatation in 2, congenital in 2, and endocarditis in 1. Operatively, all patients had annuloplasty and/or various valvuloplasty techniques, and a total of 52 procedures were concomitantly performed. Total cardiopulmonary bypass and aortic crossclamp time were 160$\pm$57 minutes and 112$\pm$45 minutes respectively. Result: Two operative deaths occurred as a result of left ventricular failure (4.5%). After the mean follow-up of 39 months (range, 10∼83 months), there was no late death. Transthoracic echocardiography revealed no or grade I of MR in 29 patients (72.5%) and no or mild MS in 35 patients (87.5%). The actuarial survival at 5 years was 100%. Four patients required mitral valve replacement due to progressive mitral valvular disease. The actuarial freedom from valve-related reoperation at 5 years was 84$\pm$9%. Conclusion: This study suggests that mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction offers good early and intermediate survival and acceptable freedom from valve-related reoperation, and it is the strategy for effective management for these patients.
Keywords
Mitral valve, repair; Ventricular dysfunction;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Mitral valve reconstruction and replacement for ischemic mitral insufficiency:seven years' follow-up /
[ Hausmann,H.;Siniawski,H.;Hetzer,R. ] / J Heart Valve Dis
2 Mitral valve repair in rheumatic disease. The flexible solution /
[ Bernal,J.M.;Rabasa,J.M.;Vichez,F.G.;Cagigas,J.C.;Revuelta,J.M. ] / Circulation   DOI   ScienceOn
3 Mitral valve replacement with preservation of papillary muscles and chordae tendinae /
[ Lillehei,C.W.;Levy,M.J.;Bonnabeau,R.C. ] / J Thorac Cardiovasc Surg
4 Is repair preferable to replacement for ischemic mitral regurgitation? /
[ Gillinov,A.M.;Wierup,P.N.;Blackstone,E.H.(et al.) ] / J Thorac Cardiovasc Surg   DOI   ScienceOn
5 Importance of subvalvular preservation and early operation in mitral valve surgery /
[ Lee,E.M.;Shapiro,L.M.;Wells,F.C. ] / Circulation   DOI   ScienceOn
6 Mitral valve repair and replacement for rheumatic disease /
[ Yau,T.M.;El-Ghoneimi,Y.A.;Armstrong,S.;Ivanov,J.;Daivd,T.E. ] / J Thorac Cardiovasc Surg   DOI   ScienceOn
7 Mitral valvuloplasty is superior to valve replacement for preservation of left ventricular function: an introperative two-dimensional echocardiographic study /
[ Goldman,M.E.;Mora,F.;Guarino,T.;Fuster,V.;Mindich,B.P. ] / J Am Coll Cardiol   DOI
8 Mitral valve repair for ischemic mitral insufficency /
[ Hendren,W.G.;Memec,J.J.;Lytle,B.W.(et al.) ] / Ann Thorac Surg   DOI   ScienceOn
9 Ischemic mitral valve disease: classification and systemic approach to management /
[ Oury,J.H.;Cleveland,J.C.;Duran,C.G.;Angell,W.W. ] / J Card Surg   DOI
10 Surgery for rheumatic mitral regurgitation in patients below twenty years of age /
[ Gometza,B.;al-Halees,Z.;Shahid,M.;Hatle,L.K.;Duran,C.M. ] / J Heart Valve Dis
11 Mitral valve surgery in patients with severe left ventricular dysfunction /
[ Bishay,E.S.;McCarthy,P.M.;Cosgrove,D.M.(et al.) ] / Eur J Cardiothorac Surg   DOI   ScienceOn
12 The effect of chordal preservation on late outcome after mitral valve replacement:a randomized study /
[ Horskotte,D.;Schulte,H.D.;Bircks,W.;Strauer,B.E. ] / J Heart Valve Dis
13 The importance of the mitral apparatus in left ventricular function after correction of mitral regurgitation /
[ David,T.E.;Uden,D.E.;Strauss,H.D. ] / Circulation   DOI
14 Left ventriculoplasty for non-ischemic cardiomyopathy with severe heart failure in 70 patients /
[ Suma,H.;Isomura,T.;Horii,T.(et al.) ] / J Cardiol   DOI   ScienceOn
15 Echocardiographic prediction of survival after surgical correction of organic mitral regurgitation /
[ Enriquez-Sarano,M.;Tajik,A.J.;Schaff,H.V.;Orszulak,T.A.;Bailey,K.R.;Frye,R.L. ] / Circulation   DOI   ScienceOn
16 Intermediate-term outcome of mitral reconstruction in cardiomyopaty /
[ Bolling,S.F.;Pagani,F.D.;Deeb,G.M.;Bach,D.S. ] / J Thorac Cardiovasc Surg   DOI   ScienceOn
17 Valve repair versus repalcement for mitral insuffiency: When is a mechanical valve still indicated ? /
[ Grossi,E.A.;Galloway,A.C.;Miller,J.S.(et al.) ] / J Thorac Cardiovasc Surg   DOI   ScienceOn
18 Efficacy of endoventricular patch plasty in large postinfarction akinetic scar and severe left ventricular dys-function: comparison with a series of large dyskinetic scars /
[ Dor,V.;Sabatier,M.;Di Donato,M.;Montiglio,F.;Toso,A.;Maioli,M. ] / J Thorac Cardiovasc Surg   DOI   ScienceOn
19 The effect of pathophysiology on the late risks of repair versus replacement /
[ Cohn,L.H.;Rizzo,R.J.;Adams,D.H.(et al.) ] / Eur J Cardiothorac Surg   DOI   ScienceOn
20 Factors affecting mitral valve reoperation in 317 survivors after mitral valve reconstruction /
[ Femandez,J.;Joyce,D.H.;Hirschfeld,K.(et al.) ] / Ann Thorac Surg   DOI   ScienceOn