scholarly journals Recent Echocardiography Parameters for Predicting Better Functional Result after Mitral Valve Correction Surgery in Patients with Primary Mitral Regurgitation

2021 ◽  
Author(s):  
Indah Puspita ◽  
Amiliana M Soesanto ◽  
Estu Rudiktyo ◽  
Rina Ariani ◽  
Ario Suryo Kuncoro
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Functional Result ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
End Diastolic Volume ◽  
Echocardiographic Parameters ◽  
Correction Surgery ◽  
Primary Mitral Regurgitation

Abstract   Objectives We analyzed whether some echocardiographic parameters are good predictors of functional result after mitral valve correction surgery.    Background Ejection fraction was not the only parameter to decide optimal time for surgery, nor an indicator for a better functional result after surgery. Severity measurement being a main consideration in surgery decision. Reduced left ventricle dimension after surgery reflect a better functional result.   Methods In 2019, 67 patients was included in this analysis. Age 53 (17-67) years, male 52,2%. All patients are with severe primary mitral regurgitation and treated by mitral valve surgery (mitral valve repair or replacement). Retrospective echocardiographic analysis was performed, to find the best parameter for predicting better functional outcome after surgery.   Results Data was collected from January to December 2019. From 262 primary mitral valve surgery underwent in National Heart Center Harapan Kita, there was 67 patients included, the other was excluded due to probability of secondary mitral regurgitation mechanism, concomitant congenital heart disease and or other significant valves disease, missing post-surgery data due to referral flow to the prior hospital and less complete echocardiographic views for further analysis. In bivariate analysis, end-diastolic volume (EDV) and regurgitant volume (RV) were strong predictor of decreasing left ventricle diameter after surgery (p 0.0001 and p 0.05). End-diastolic volume 133,5 ml or more is predictive for decreasing left ventricle diameter if surgery was conducted (sensitivity 87.3%, sensitivity 66.7%).       Conclusions EDV and RV found to be good predictors for functional outcome of primary mitral valve surgery than other echocardiographic parameters. Measuring EDV before deciding timing of surgery will be helpful in targeting better functional result after surgery.    

scholarly journals Myocardial adaptation as assessed by speckle tracking echocardiography after isolated mitral valve surgery for primary mitral regurgitation

2020 ◽  
Author(s):  
Muhammed Gerçek ◽  
Lothar Faber ◽  
Volker Rudolph ◽  
Henrik Fox ◽  
Thomas Puehler ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Tricuspid Regurgitation ◽  
Exercise Tolerance ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Contractile Function ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Primary Mitral Regurgitation

Abstract The risk of left ventricular (LV) and right ventricular (RV) maladaptation after surgery for isolated primary mitral regurgitation (PMR) is poorly defined. We aimed to evaluate LV and RV contractile function using speckle-tracking analysis alongside with quantification of exercise tolerance in patients with PMR after mitral valve surgery. All consecutive patients with symptomatic PMR undergoing mitral valve surgery between July 2015 and May 2017 were prospectively enrolled. Sequential echocardiographic studies along with clinical assessment were performed before and three months after surgery. Mean age in 138 patients was 65.8 ± 12.7 years, 48.2% (66) of whom were female. Mean LV ejection fraction decreased from 57 ± 12% to 50 ± 11% (p < 0.001), LV global longitudinal strain deteriorated from −19.2 ± 4.1% to −15.7 ± 3.8% (p < 0.001), and mechanical strain dispersion increased from 88 ± 12 to 117 ± 115 ms (p = 0.004). There was a reduction in tricuspid annulus plane systolic excursion from 22 ± 5 mm to 18 ± 4 mm (p < 0.001), as well as a slight deterioration of RV free wall mean longitudinal strain from −16.9 ± 5.6% to −15.7 ± 4.1% (p = 0.05). The rate of moderate to severe tricuspid regurgitation significantly decreased (p < 0.005). Regarding exercise tolerance, the New York Heart Association class improved (p < 0.001) and the walking distance increased (p < 0.001). During mid-term follow up after surgery for PMR, a deterioration of LV and RV contractile function measures could be observed. However, the clinical status, LV dimensions, and concomitant tricuspid regurgitation improved which in particular imply more effective RV contractile pattern.

Hemodynamic and energetic aspects of the left ventricle in patients with mitral regurgitation before and after mitral valve surgery

2015 ◽  
Vol 42 (6) ◽  
pp. 1705-1712 ◽  
Author(s):  
Nadya Al-Wakeel ◽  
Joao Filipe Fernandes ◽  
Aref Amiri ◽  
Henryk Siniawski ◽  
Leonid Goubergrits ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Before And After

Invasive exercise hemodynamics in patients with severe primary mitral regurgitation and preserved ejection fraction predicts future valve surgery

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Hein ◽  
J.N Neu ◽  
S.D Dorfs ◽  
S.D Doerken ◽  
W.Z Zeh ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Mitral Valve Surgery ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Non Invasive ◽  
Asymptomatic Patients ◽  
Exercise Hemodynamics ◽  
Primary Mitral Regurgitation

Abstract Background The role of invasive exercise hemodynamics in the management of asymptomatic patients with severe primary mitral regurgitation (MR) is unclear. Methods and results We compared the predictive power of parameters of invasive exercise testing for future valve surgery to guideline-defined non-invasive criteria. Maximal pulmonary capillary wedge pressure (PCWP), PCWP normalized to workload and weight (PCWL), and invasive maximal systolic pulmonary artery pressure (SPAP) were assessed in 113 asymptomatic patients with severe primary MR between 1996 and 2012. Mean age was 52±11 years, 16% were female, ejection fraction was ≥55% in all patients. During a median follow up of 4.5 years (IQR2.0; 8.3) 54 patients (48%) underwent valve surgery. In univariate analysis PCWP (P&lt;0.001), PCWL (P&lt;0.001), and maximal SPAP (P=0.009) were significantly associated with future mitral valve surgery. In multivariate analysis maximum PCWP and PCWL predicted future mitral valve surgery (HR 2.1 (1.44–3.10), P=0.005 and HR 1.31 (1.14–1.52), P&lt;0.001, respectively) whereas SPAP did not. Adding maximum PCWP &gt;25mmHg to a Cox regression model based on non-invasive guideline criteria resulted in a significant increase in the area under the curve (0.61 to 0.68, P=0.02). Conclusion In asymptomatic patients with severe primary mitral regurgitation and preserved left ventricular function invasive exercise hemodynamics improves information derived from current non-invasive guideline criteria. Figure 1 Funding Acknowledgement Type of funding source: None

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