Mitral valve annuloplasty versus no intervention for mild‐to‐moderate secondary mitral regurgitation in severe aortic regurgitation: a propensity‐score matched analysis

2019 ◽  
Vol 34 (12) ◽  
pp. 1498-1504
Author(s):  
Yi Lin ◽  
Kanhua Yin ◽  
Zhiqi Zhang ◽  
Zhaohua Yang ◽  
Changfa Guo ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Propensity Score ◽  
Mitral Regurgitation ◽  
Aortic Regurgitation ◽  
Severe Aortic Regurgitation ◽  
Mitral Valve Annuloplasty ◽  
Secondary Mitral Regurgitation

scholarly journals Echocardiographic versus Histologic Findings in Marfan Syndrome

2015 ◽  
Vol 42 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Xiaoyan Gu ◽  
Yihua He ◽  
Zhian Li ◽  
Jiancheng Han ◽  
Jian Chen ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Aortic Regurgitation ◽  
Marfan Syndrome ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Severe Mitral Regurgitation ◽  
Severe Aortic Regurgitation ◽  
Myxomatous Degeneration ◽  
Histologic Changes

This retrospective study attempted to establish the prevalence of multiple-valve involvement in Marfan syndrome and to compare echocardiographic with histopathologic findings in Marfan patients undergoing valvular or aortic surgery. We reviewed echocardiograms of 73 Marfan patients who underwent cardiovascular surgery from January 2004 through October 2009. Tissue histology was available for comparison in 29 patients. Among the 73 patients, 66 underwent aortic valve replacement or the Bentall procedure. Histologic findings were available in 29 patients, all of whom had myxomatous degeneration. Of 63 patients with moderate or severe aortic regurgitation as determined by echocardiography, 4 had thickened aortic valves. The echocardiographic findings in 18 patients with mitral involvement included mitral prolapse in 15. Of 11 patients with moderate or severe mitral regurgitation as determined by echocardiography, 4 underwent mitral valve repair and 7 mitral valve replacement. Histologic findings among mitral valve replacement patients showed thickened valve tissue and myxomatous degeneration. Tricuspid involvement was seen echocardiographically in 8 patients, all of whom had tricuspid prolapse. Two patients had severe tricuspid regurgitation, and both underwent repair. Both mitral and tricuspid involvement were seen echocardiographically in 7 patients. Among the 73 patients undergoing cardiac surgery for Marfan syndrome, 66 had moderate or severe aortic regurgitation, although their valves manifested few histologic changes. Eighteen patients had mitral involvement (moderate or severe mitral regurgitation, prolapse, or both), and 8 had tricuspid involvement. Mitral valves were most frequently found to have histologic changes, but the tricuspid valve was invariably involved.

Severe aortic regurgitation immediately after mitral valve annuloplasty

1999 ◽  
Vol 67 (5) ◽  
pp. 1487-1489 ◽  
Author(s):  
Anique Ducharme ◽  
Jean-François Courval ◽  
Annie Dore ◽  
Yves Leclerc ◽  
Jean-Claude Tardif
Keyword(s):  
Mitral Valve ◽  
Aortic Regurgitation ◽  
Severe Aortic Regurgitation ◽  
Mitral Valve Annuloplasty

Outcome and durability of mitral valve annuloplasty in atrial secondary mitral regurgitation

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319045
Author(s):  
Sébastien Deferm ◽  
Philippe B Bertrand ◽  
David Verhaert ◽  
Jeroen Dauw ◽  
Jan M Van Keer ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Patient Characteristics ◽  
Left Ventricular ◽  
Type I ◽  
Therapeutic Implications ◽  
Mitral Valve Annuloplasty ◽  
All Cause Mortality ◽  
Secondary Mitral Regurgitation ◽  
Secondary Mr

ObjectivesAtrial secondary mitral regurgitation (ASMR) is a clinically distinct form of Carpentier type I mitral regurgitation (MR), rooted in excessive atrial and mitral annular dilation in the absence of left ventricular dysfunction. Mitral valve annuloplasty (MVA) is expected to provide a more durable solution for ASMR than for ventricular secondary MR (VSMR). Yet data on MR recurrence and outcome after MVA for ASMR are scarce. This study sought to investigate surgical outcomes and repair durability in patients with ASMR, as compared with a contemporary group of patients with VSMR.MethodsClinical and echocardiographic data from consecutive patients who underwent MVA to treat ASMR or VSMR in an academic centre were retrospectively analysed. Patient characteristics, operative outcomes, time to recurrence of ≥moderate MR and all-cause mortality were compared between patients with ASMR versus VSMR.ResultsOf the 216 patients analysed, 97 had ASMR opposed to 119 with VSMR and subvalvular leaflet tethering. Patients with ASMR were typically female (68.0% vs 33.6% in VSMR, p<0.001), with a history of atrial fibrillation (76.3% vs 33.6% in VSMR, p<0.001), paralleling a larger left atrial size (p<0.033). At a median follow-up of 3.3 (IQR 1.0–7.3) years, recurrence of ≥moderate MR was significantly lower in ASMR versus VSMR (7% vs 25% at 2 years, overall log-rank p=0.001), also when accounting for all-cause death as competing risk (subdistribution HR 0.50 in ASMR, 95% CI 0.29 to 0.88, p=0.016). Moreover, ASMR was associated with better overall survival compared with VSMR (adjusted HR 0.43 95% CI 0.22 to 0.82, p=0.011), independent from baseline European System for Cardiac Operative Risk Evaluation II surgical risk score.ConclusionPrognosis following MVA to treat ASMR is better, compared with VSMR as reflected by lower all-cause mortality and MR recurrence. Early distinction of secondary MR towards underlying ventricular versus atrial disease has important therapeutic implications.

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