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01.12.2009 | Research | Ausgabe 1/2009 Open Access

Cardiovascular Ultrasound 1/2009

Influence of involvement of anterior leaflet versus posterior leaflet on residual regurgitation as assessed by transesophageal echocardiography in patients undergoing valve repair for mitral regurgitation due to mitral valve prolapse

Zeitschrift:
Cardiovascular Ultrasound > Ausgabe 1/2009
Autoren:
Laureta Sulcaj, Antonio Rizza, Mattia Glauber, Giuseppe Trianni, Cataldo Palmieri, Marcello Ravani, Alban Dibra, Stefano Maffei, Sergio Berti
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

LS, AR, and SB conceived and designed the study; LS, AR, GT, CP, MR, and SM participated in patient selection and performed echocardiographic analysis; MG carried out the mitral valve repair; LS and AR gathered the data; LS, AR, AD, and SB performed the statistical analysis and interpreted the data; LS drafted the manuscript; AR, MG, GT, CP, MR, AD, SM, and SB critically revised the manuscript; AR and SB provided administrative, technical, or material support; SB supervised the study. All authors read and approved the final version of the manuscript.

Abstract

Background

Repair of anterior leaflet prolapse is technically more challenging and this might influence outcomes as compared to the repair of posterior leaflet prolapse in patients undergoing surgical correction of mitral regurgitation. We investigated the association of anterior leaflet prolapse with minor residual mitral regurgitation (MR) in patients with mitral valve prolapse (MVP) who underwent valve repair.

Methods

Eligible for this study were consecutive patients with severe MR due to MVP, who underwent mitral valve repair with residual MR by postpump transesophageal echocardiography ≤2+ during a 20-month period at Pasquinucci Hospital, Massa. Patients undergoing other cardiovascular surgical interventions were excluded. Two groups were defined according to the involvement of mitral valve leaflets: group 1, consisting of patients with anterior leaflet prolapse (isolated or not); and group 2, consisting of patients with isolated posterior leaflet prolapse.

Results

A total of 70 patients (18 in group 1 and 52 in group 2) were analyzed. Patients in group 2 were younger than those in group 1, but the difference was not significant (P = 0.052). There were no significant differences between the 2 study groups with respect to other variables. The proportion of patients with residual MR 1+/2+ was higher in group 1 than in group 2 (61.1% vs. 32.7%, respectively; P = 0.034). In a logistic regression model, anterior leaflet prolapse was an independent predictor of residual MR 1+/2+ (odds ratio, 4.0; 95% confidence interval, 1.14 to 14.04; P = 0.03).

Conclusion

In our study population, patients with anterior leaflet prolapse had a higher proportion of residual MR 1+/2+ as compared to those with posterior leaflet prolapse after repair of mitral valve.
Literatur
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