Mechanisms of Recurrent Functional Mitral Regurgitation After Mitral Valve Repair in Nonischemic Dilated Cardiomyopathy: Importance of Distal Anterior Leaflet Tethering

Recurrent functional mitral regurgitation (MR) has been reported after mitral valve repair with annuloplasty in patients with dilated cardiomyopathy, but the mechanism is not understood completely. The authors sought to identify abnormalities of the mitral valve and left ventricle that are associate...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2009-05, Vol.119 (19), p.2606-2614
Main Authors: PUI-WAI LEE, Alex, ACKER, Michael, KUBO, Spencer H, BOLLING, Steven F, PARK, Seung W, BRUCE, Charles J, OH, Jae K
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Cardiomyopathy, Dilated - physiopathology
Cardiomyopathy, Dilated - surgery
Chordae Tendineae - pathology
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Female
Heart Ventricles - pathology
Humans
Male
Medical sciences
Middle Aged
Mitral Valve - physiopathology
Mitral Valve - surgery
Mitral Valve Insufficiency - etiology
Mitral Valve Insufficiency - physiopathology
Models, Cardiovascular
Motion
Multicenter Studies as Topic - statistics & numerical data
Papillary Muscles - pathology
Prospective Studies
Randomized Controlled Trials as Topic - statistics & numerical data
Recurrence
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
Citations: Items that this one cites
Online Access:Get full text
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Description
Summary:Recurrent functional mitral regurgitation (MR) has been reported after mitral valve repair with annuloplasty in patients with dilated cardiomyopathy, but the mechanism is not understood completely. The authors sought to identify abnormalities of the mitral valve and left ventricle that are associated with recurrent MR after mitral annuloplasty. In 104 patients with idiopathic dilated cardiomyopathy who underwent annuloplasty for functional MR, basal mitral anterior leaflet angle, distal mitral anterior leaflet angle (ALAtip), posterior leaflet angle, coaptation depth, tenting area, mitral annular dimensions, left ventricular volumes, and MR severity were quantified by echocardiography before surgery and at 6-month intervals after it. Compared with patients without MR recurrence (n=79), patients with recurrent MR (defined as > or =2+) (n=25) had greater ALAtip (P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.108.796151