HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Steven F. Bolling G. Michael Deeb Louis A. Brunsting Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bolling, S. F. Articles by Bach, D. S. Search for Related Content PubMed PubMed Citation Articles by Bolling, S. F. Articles by Bach, D. S.

J Thorac Cardiovasc Surg 1995;109:676-683
© 1995 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

Early outcome of mitral valve reconstruction in patients with end-stage cardiomyopathy

Ann Arbor, Mich.

From the Departments of Thoracic Surgery and Cardiology, the University of Michigan, Ann Arbor, Mich.

Address for reprints: Steven F. Bolling, MD, The University of Michigan Hospitals, Section of Thoracic Surgery, 2120D Taubman Center; Box 0344, Ann Arbor, MI 48109.

Abstract

Uncontrollable severe mitral regurgitation is a frequent complication of end-stage cardiomyopathy, significantly contributing to heart failure in these patients, and predicts a poor survival. Although elimination of mitral valve regurgitation could be most beneficial in this group, corrective mitral valve surgery has not been routinely undertaken in these very ill patients because of the presumed prohibitive operative mortality. We studied the early outcome of mitral valve reconstruction in 16 consecutive patients with cardiomyopathy and severe, refractory mitral regurgitation operated on between June 1993 and April 1994. There were 11 men and five women, aged 44 to 78 years (64 ± 8 years) with left ventricular ejection fractions of 9% to 25% (16% ± 5%). Preoperatively all patients were in New York Heart Association class IV, had severe mitral regurgitation (graded 0 to 4+according to color flow Doppler transesophageal echocardiography) and two were listed for transplantation. Operatively, a flexible annuloplasty ring was implanted in all patients. Four patients also had single coronary bypass grafting for incidental coronary disease. In four patients the operation was performed through a right thoracotomy because of prior coronary bypass grafting, and four patients also underwent tricuspid valve reconstruction for severe tricuspid regurgitation. No patient required support with an intraaortic balloon pump. There were no operative or hospital deaths and mean hospital stay was 10 days. There were three late deaths at 2, 6, and 7 months after mitral valve reconstruction, and the 1-year actuarial survival has been 75%. At a mean follow-up of 8 months, all remaining patients are in New York Heart Association class I or II, with a mean postoperative ejection fraction of 25% ± 10%. There have been no hospitalizations for congestive heart failure, and a decrease in medications required has been noted. For patients with cardiomyopathy and severe mitral regurgitation, mitral valve reconstruction as opposed to replacement can be accomplished with low operative and early mortality. Although longer term follow-up is mandatory, mitral valve reconstruction may allow new strategies for patients with end-stage cardiomyopathy and severe mitral regurgitation, yielding improvement in symptomatic status and survival. (J THORAC CARDIOVASC SURG 1995;109:676-83)

This article has been cited by other articles:

				M. L. Williams, M. A. Daneshmand, J. G. Jollis, J. R. Horton, L. K. Shaw, M. Swaminathan, R. D. Davis, D. D. Glower, P. K. Smith, and C. A. Milano Mitral gradients and frequency of recurrence of mitral regurgitation after ring annuloplasty for ischemic mitral regurgitation. Ann. Thorac. Surg., October 1, 2009; 88(4): 1197 - 1201. [Abstract] [Full Text] [PDF]

				J. Magne, N. Girerd, M. Senechal, P. Mathieu, F. Dagenais, J. G. Dumesnil, E. Charbonneau, P. Voisine, and P. Pibarot Mitral Repair versus Replacement for Ischemic Mitral Regurgitation: Comparison of Short-Term and Long-Term Survival Circulation, September 15, 2009; 120(11_suppl_1): S104 - S111. [Abstract] [Full Text] [PDF]

				S. Silberman, M. W. Klutstein, T. Sabag, A. Oren, D. Fink, O. Merin, and D. Bitran Repair of Ischemic Mitral Regurgitation: Comparison Between Flexible and Rigid Annuloplasty Rings. Ann. Thorac. Surg., June 1, 2009; 87(6): 1721 - 1727. [Abstract] [Full Text] [PDF]

				T. A. Timek, D. Liang, G. T. Daughters, N. B. Ingels Jr., and D. C. Miller Effect of local annular interventions on annular and left ventricular geometry Eur. J. Cardiothorac. Surg., June 1, 2008; 33(6): 1049 - 1054. [Abstract] [Full Text] [PDF]

				K.-u Fumimoto, T. Fukui, T. Shimokawa, and S. Takanashi Papillary muscle realignment and mitral annuloplasty in patients with severe ischemic mitral regurgitation and dilated heart Interactive CardioVascular and Thoracic Surgery, June 1, 2008; 7(3): 368 - 371. [Abstract] [Full Text] [PDF]

				J. Braun, N. R. van de Veire, R. J.M. Klautz, M. I.M. Versteegh, E. R. Holman, J. J.M. Westenberg, E. Boersma, E. E. van der Wall, J. J. Bax, and R. A.E. Dion Restrictive Mitral Annuloplasty Cures Ischemic Mitral Regurgitation and Heart Failure Ann. Thorac. Surg., February 1, 2008; 85(2): 430 - 437. [Abstract] [Full Text] [PDF]

				M. T. Spoor and S. F. Bolling Nontransplant Surgical Options for Heart Failure Card. Surg. Adult, January 1, 2008; 3(2008): 1639 - 1648. [Full Text]

				L. P. Ryan, B. M. Jackson, L. M. Parish, H. Sakamoto, T. J. Plappert, M. St. John-Sutton, J. H. Gorman III, and R. C. Gorman Mitral Valve Tenting Index for Assessment of Subvalvular Remodeling Ann. Thorac. Surg., October 1, 2007; 84(4): 1243 - 1249. [Abstract] [Full Text] [PDF]

				E. Votta, F. Maisano, S. F. Bolling, O. Alfieri, F. M. Montevecchi, and A. Redaelli The Geoform Disease-Specific Annuloplasty System: A Finite Element Study Ann. Thorac. Surg., July 1, 2007; 84(1): 92 - 101. [Abstract] [Full Text] [PDF]

				T. Mihaljevic, B.-K. Lam, J. Rajeswaran, M. Takagaki, M. S. Lauer, A. M. Gillinov, E. H. Blackstone, and B. W. Lytle Impact of Mitral Valve Annuloplasty Combined With Revascularization in Patients With Functional Ischemic Mitral Regurgitation J. Am. Coll. Cardiol., June 5, 2007; 49(22): 2191 - 2201. [Abstract] [Full Text] [PDF]

				G. DiGiammarco, R. Liberi, M. Giancane, C. Canosa, S. Gallina, A. Di Francesco, G. Spira, and M. Di Mauro Recurrence of functional mitral regurgitation in patients with dilated cardiomyopathy undergoing mitral valve repair: how to predict it Interactive CardioVascular and Thoracic Surgery, June 1, 2007; 6(3): 340 - 344. [Abstract] [Full Text] [PDF]

				J. Kwan, M. A. Gillinov, J. D. Thomas, and T. Shiota Geometric predictor of significant mitral regurgitation in patients with severe ischemic cardiomyopathy, undergoing Dor procedure: A real-time 3D echocardiographic study Eur J Echocardiogr, June 1, 2007; 8(3): 195 - 203. [Abstract] [Full Text] [PDF]

				B.-C. Chang, Y.-N. Youn, J.-W. Ha, S.-H. Lim, Y.-S. Hong, and N. Chung Long-term clinical results of mitral valvuloplasty using flexible and rigid rings: A prospective and randomized study J. Thorac. Cardiovasc. Surg., April 1, 2007; 133(4): 995 - 1003. [Abstract] [Full Text] [PDF]

				J. Magne, P. Pibarot, F. Dagenais, Z. Hachicha, J. G. Dumesnil, and M. Senechal Preoperative Posterior Leaflet Angle Accurately Predicts Outcome After Restrictive Mitral Valve Annuloplasty for Ischemic Mitral Regurgitation Circulation, February 13, 2007; 115(6): 782 - 791. [Abstract] [Full Text] [PDF]

				T. Horii, H. Suma, T. Isomura, F. Nomura, and J. Hoshino Left ventricle volume affects the result of mitral valve surgery for idiopathic dilated cardiomyopathy to treat congestive heart failure. Ann. Thorac. Surg., October 1, 2006; 82(4): 1349 - 1355. [Abstract] [Full Text] [PDF]

				M. Toyama, A. Usui, T. Abe, H. Oshima, T. Akita, and Y. Ueda Mitral Valve Surgery for Dilated Cardiomyopathy with Mitral Regurgitation Asian Cardiovasc Thorac Ann, October 1, 2006; 14(5): 371 - 376. [Abstract] [Full Text] [PDF]

				J J Bax and D Poldermans Mitral regurgitation and left ventricular dyssynchrony: implications for treatment Heart, October 1, 2006; 92(10): 1363 - 1364. [Abstract] [Full Text] [PDF]

				D. Maselli, F. Guarracino, F. Chiaramonti, F. Mangia, G. Borelli, and G. Minzioni Percutaneous Mitral Annuloplasty: An Anatomic Study of Human Coronary Sinus and Its Relation With Mitral Valve Annulus and Coronary Arteries Circulation, August 1, 2006; 114(5): 377 - 380. [Abstract] [Full Text] [PDF]

				A. M. Calafiore, M. Di Mauro, A. L. Iaco, V. Mazzei, G. Teodori, S. Gallina, L. Weltert, M. Samoun, and G. Di Giammarco Overreduction of the Posterior Annulus in Surgical Treatment of Degenerative Mitral Regurgitation Ann. Thorac. Surg., April 1, 2006; 81(4): 1310 - 1316. [Abstract] [Full Text] [PDF]

				M. Di Donato, P. Dabic, S. Castelvecchio, C. Santambrogio, J. Brankovic, L. Collarini, T. Joussef, A. Frigiola, G. Buckberg, L. Menicanti, et al. Left ventricular geometry in normal and post-anterior myocardial infarction patients: sphericity index and 'new' conicity index comparisons Eur. J. Cardiothorac. Surg., April 1, 2006; 29(Suppl_1): S225 - S230. [Abstract] [Full Text] [PDF]

				E. Buffolo, J. N. R. Branco, R. Catani, and the RESTORE Group End-stage cardiomyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular restoration Eur. J. Cardiothorac. Surg., April 1, 2006; 29(Suppl_1): S266 - S271. [Abstract] [Full Text] [PDF]

				R. De Simone, I. Wolf, S. Mottl-Link, R. Hoda, B. Mikhail, F.-U. Sack, H.-P. Meinzer, and S. Hagl A clinical study of annular geometry and dynamics in patients with ischemic mitral regurgitation: new insights into asymmetrical ring annuloplasty Eur. J. Cardiothorac. Surg., March 1, 2006; 29(3): 355 - 361. [Abstract] [Full Text] [PDF]

				J. J.M. Westenberg, R. J. van der Geest, H. J. Lamb, M. I.M. Versteegh, J. Braun, J. Doornbos, A. de Roos, E. E. van der Wall, R. A.E. Dion, J. H.C. Reiber, et al. MRI to Evaluate Left Atrial and Ventricular Reverse Remodeling After Restrictive Mitral Annuloplasty in Dilated Cardiomyopathy Circulation, August 30, 2005; 112(9_suppl): I-437 - I-442. [Abstract] [Full Text] [PDF]

				S. A.F. Tulner, P. Steendijk, R. J.M. Klautz, J. J. Bax, M. I.M. Versteegh, E. E. van der Wall, and R. A.E. Dion Acute hemodynamic effects of restrictive mitral annuloplasty in patients with end-stage heart failure: Analysis by pressure-volume relations J. Thorac. Cardiovasc. Surg., July 1, 2005; 130(1): 33 - 40. [Abstract] [Full Text] [PDF]

				A. Zangrillo, G. Crescenzi, G. Landoni, S. Benussi, M. Crivellari, F. Pappalardo, E. Dorigo, C. Pappone, and O. Alfieri The Effect of Concomitant Radiofrequency Ablation and Surgical Technique (Repair Versus Replacement) on Release of Cardiac Biomarkers During Mitral Valve Surgery Anesth. Analg., July 1, 2005; 101(1): 24 - 29. [Abstract] [Full Text] [PDF]

				S. Geidel, M. Lass, C. Schneider, G. Groth, S. Boczor, K.-H. Kuck, and J. Ostermeyer Downsizing of the mitral valve and coronary revascularization in severe ischemic mitral regurgitation results in reverse left ventricular and left atrial remodeling Eur. J. Cardiothorac. Surg., June 1, 2005; 27(6): 1011 - 1016. [Abstract] [Full Text] [PDF]

				D. L. Mann and M. R. Bristow Mechanisms and Models in Heart Failure: The Biomechanical Model and Beyond Circulation, May 31, 2005; 111(21): 2837 - 2849. [Full Text] [PDF]

				F. Maisano, A. Redaelli, M. Soncini, E. Votta, L. Arcobasso, and O. Alfieri An Annular Prosthesis for the Treatment of Functional Mitral Regurgitation: Finite Element Model Analysis of a Dog Bone-Shaped Ring Prosthesis Ann. Thorac. Surg., April 1, 2005; 79(4): 1268 - 1275. [Abstract] [Full Text] [PDF]

				A. M. Calafiore, M. Di Mauro, M. Contini, L. Weltert, and A. Bivona Mitral valve repair in ischemic mitral regurgitation MMCTS, March 24, 2005; 2005(0324): 521. [Abstract] [Full Text] [PDF]

				F. Maisano, Z. Ziskind, A. Grimaldi, A. Blasio, A. Caldarola, M. De Bonis, G. La Canna, and O. Alfieri Selective reduction of the septolateral dimensions in functional mitral regurgitation by modified-shape ring annuloplasty J. Thorac. Cardiovasc. Surg., February 1, 2005; 129(2): 472 - 474. [Full Text] [PDF]

				K. D. O'Brien and D. P. Fishbein Mitral valve abnormalities in congestive heart failure: An interplay between form and function? J. Am. Coll. Cardiol., January 4, 2005; 45(1): 62 - 64. [Full Text] [PDF]

				J. J. Bax, J. Braun, S. T. Somer, R. Klautz, E. R. Holman, M. I.M. Versteegh, E. Boersma, M. J. Schalij, E. E. van der Wall, and R. A. Dion Restrictive Annuloplasty and Coronary Revascularization in Ischemic Mitral Regurgitation Results in Reverse Left Ventricular Remodeling Circulation, September 14, 2004; 110(11_suppl_1): II-103 - II-108. [Abstract] [Full Text] [PDF]

				C. K. Haan, C. I. Cabral, D. A. Conetta, L. P. Coombs, and F. H. Edwards Selecting patients with mitral regurgitation and left ventricular dysfunction for isolated mitral valve surgery Ann. Thorac. Surg., September 1, 2004; 78(3): 820 - 825. [Abstract] [Full Text] [PDF]

				B. Pieske Reverse remodeling in heart failure - fact or fiction? Eur. Heart J. Suppl., August 1, 2004; 6(suppl_D): D66 - D78. [Abstract] [Full Text] [PDF]

				J.-P. Chang and C.-L. Kao Mitral valve repair in uremic congestive cardiomyopathy Ann. Thorac. Surg., September 1, 2003; 76(3): 694 - 697. [Abstract] [Full Text] [PDF]

				A. M. Calafiore, M. Di Mauro, S. Gallina, C. Canosa, and A. L. Iaco Optimal length of pericardial strip for posterior mitral overreductive annuloplasty Ann. Thorac. Surg., June 1, 2003; 75(6): 1982 - 1984. [Abstract] [Full Text] [PDF]

				J. F. Gummert, A. Rahmel, J. Bucerius, J. Onnasch, N. Doll, T. Walther, V. Falk, and F. W. Mohr Mitral valve repair in patients with end stage cardiomyopathy: who benefits? Eur. J. Cardiothorac. Surg., June 1, 2003; 23(6): 1017 - 1022. [Abstract] [Full Text] [PDF]

				Zoltan. A. Szalay, A. Civelek, S. Hohe, H.-P. Brunner-LaRocca, W.-P. Klovekorn, I. Knez, P. R. Vogt, and E. P. Bauer Mitral annuloplasty in patients with ischemic versus dilated cardiomyopathy Eur. J. Cardiothorac. Surg., April 1, 2003; 23(4): 567 - 572. [Abstract] [Full Text] [PDF]

				T. Isomura, H. Suma, A. Yamaguchi, T. Kobashi, and A. Yuda Left ventricular restoration for ischemic cardiomyopathy - comparison of presence and absence of mitral valve procedure Eur. J. Cardiothorac. Surg., April 1, 2003; 23(4): 614 - 619. [Abstract] [Full Text] [PDF]

				V. Badhwar and S. F. Bolling Nontransplant Surgical Options for Heart Failure Card. Surg. Adult, January 1, 2003; 2(2003): 1515 - 1526. [Full Text]

				L. Menicanti, M. Di Donato, A. Frigiola, G. Buckberg, C. Santambrogio, M. Ranucci, and D. Santo Ischemic mitral regurgitation: Intraventricular papillary muscle imbrication without mitral ring during left ventricular restoration J. Thorac. Cardiovasc. Surg., June 1, 2002; 123(6): 1041 - 1050. [Abstract] [Full Text] [PDF]

				R. Tavakoli, A. Weber, H. Brunner-La Rocca, D. Bettex, P. Vogt, R. Pretre, R. Jenni, and M. Turina Results of surgery for irreversible moderate to severe mitral valve regurgitation secondary to myocardial infarction Eur. J. Cardiothorac. Surg., May 1, 2002; 21(5): 818 - 824. [Abstract] [Full Text] [PDF]

				V. Torbica, M. Mijatov, and M. Popov Reductive annuloplasty of double orifices in patients with primary dilated cardiomyopathy Ann. Thorac. Surg., March 1, 2002; 73(3): 751 - 755. [Abstract] [Full Text] [PDF]

				T. Isomura, H. Suma, T. Horii, T. Sato, T. Kobashi, H. Kanemitsu, J. Hoshino, and K. Hisatomi Left ventricle restoration in patients with non-ischemic dilated cardiomyopathy: risk factors and predictors of outcome and change of mid-term ventricular function Eur. J. Cardiothorac. Surg., May 1, 2001; 19(5): 684 - 689. [Abstract] [Full Text] [PDF]

				F. Grigioni, M. Enriquez-Sarano, K. J. Zehr, K. R. Bailey, and A. J. Tajik Ischemic Mitral Regurgitation : Long-Term Outcome and Prognostic Implications With Quantitative Doppler Assessment Circulation, April 3, 2001; 103(13): 1759 - 1764. [Abstract] [Full Text] [PDF]

				A. M. Calafiore, S. Gallina, M. Di Mauro, F. Gaeta, A. L. Iaco, S. D'Alessandro, V. Mazzei, and G. Di Giammarco Mitral valve procedure in dilated cardiomyopathy: repair or replacement? Ann. Thorac. Surg., April 1, 2001; 71(4): 1146 - 1152. [Abstract] [Full Text] [PDF]

				I. A. Smolens, F. D. Pagani, and S. F. Bolling Mitral valve repair in heart failure Eur J Heart Fail, December 1, 2000; 2(4): 365 - 371. [Abstract] [Full Text] [PDF]

				S. F. Yiu, M. Enriquez-Sarano, C. Tribouilloy, J. B. Seward, and A. J. Tajik Determinants of the Degree of Functional Mitral Regurgitation in Patients With Systolic Left Ventricular Dysfunction : A Quantitative Clinical Study Circulation, September 19, 2000; 102(12): 1400 - 1406. [Abstract] [Full Text] [PDF]

				J. R Pepper Surgery for heart failure: options and outcomes Perfusion, July 1, 2000; 15(4): 287 - 293. [PDF]

				M E Lewis, M P. Pitt, and R S Bonser Surgical alternatives to mechanical support Perfusion, July 1, 2000; 15(4): 379 - 386. [PDF]

				E. S. Bishay, P. M. McCarthy, D. M. Cosgrove, K. J. Hoercher, N. G. Smedira, D. Mukherjee, J. White, and E. H. Blackstone Mitral valve surgery in patients with severe left ventricular dysfunction Eur. J. Cardiothorac. Surg., March 1, 2000; 17(3): 213 - 221. [Abstract] [Full Text] [PDF]

				T. Isomura, H. Suma, T. Horii, T. Sato, and N. Kikuchi Partial left ventriculectomy, ventriculoplasty or valvular surgery for idiopathic dilated cardiomyopathy - the role of intra-operative echocardiography Eur. J. Cardiothorac. Surg., March 1, 2000; 17(3): 239 - 245. [Abstract] [Full Text] [PDF]

				L. H. Cohn WHAT THE CARDIOTHORACIC SURGEON OF THE TWENTY-FIRST CENTURY OUGHT TO BE J. Thorac. Cardiovasc. Surg., October 1, 1999; 118(4): 581 - 587. [Full Text] [PDF]

				J. F. McCarthy, P. M. McCarthy, R. C. Starling, N. G. Smedira, G. M. Scalia, J. Wong, V. Kasirajan, M. Goormastic, and J. B. Young Partial left ventriculectomy and mitral valve repair for end-stage congestive heart failure Eur. J. Cardiothorac. Surg., April 1, 1999; 13(4): 337 - 343. [Abstract] [Full Text] [PDF]

				N. A.G. Stolf, L. F. P. Moreira, E. A. Bocchi, M. de Lourdes Higuchi, F. Bacal, G. Bellotti, and A. D. Jatene Determinants of midterm outcome of partial left ventriculectomy in dilated cardiomyopathy Ann. Thorac. Surg., November 1, 1998; 66(5): 1585 - 1591. [Abstract] [Full Text] [PDF]

				L. F. P. Moreira, N. A. G. Stolf, E. A. Bocchi, F. Bacal, M. C. P. Giorgi, J. R. Parga, and A. D. Jatene Partial left ventriculectomy with mitral valve preservation in the treatment of patients with dilated cardiomyopathy J. Thorac. Cardiovasc. Surg., April 1, 1998; 115(4): 800 - 807. [Abstract] [Full Text] [PDF]

				P. M. McCarthy, R. C. Starling, J. Wong, G. M. Scalia, T. Buda, R. L. Vargo, MSN, M. Goormastic, J. D. Thomas, N. G. Smedira, et al. EARLY RESULTS WITH PARTIAL LEFT VENTRICULECTOMY J. Thorac. Cardiovasc. Surg., November 1, 1997; 114(5): 755 - 765. [Abstract] [Full Text]

				Y. Kameda, S. Kitamura, K. Kawachi, and T. Kawata Annuloplasty for Severe Mitral Regurgitation Due to Dilated Cardiomyopathy Ann. Thorac. Surg., June 1, 1996; 61(6): 1829 - 1832. [Abstract] [Full Text]