Background
Methods
Patients
Echocardiographic measurements
Systolic mitral leaflet closure
Diastolic mitral leaflet excursion
Surgical technique
Statistical analysis
Results
Baseline characteristics
RMAP | Posterior PMR | Anterior PMR | P-value | |
---|---|---|---|---|
(n = 23) | (n = 10) | (n = 6) | ||
Age, years
| 70 ± 6 | 65 ± 7 | 68 ± 8 | 0.16 |
Male
| 17 (73.9) | 9 (90.0) | 3 (50.0) | 0.21 |
NYHA functional class
| ||||
1
| 2 (8.7) | 0 | 0 | 0.48 |
2
| 12 (52.2) | 3 (30.0) | 1 (16.7) | 0.21 |
3
| 8 (34.8) | 4 (40.0) | 3 (50.0) | 0.79 |
4
| 1 (4.3) | 3 (30.0) | 2 (33.3) | 0.071 |
Preoperative inotropic support
| 2 (8.7) | 3 (30.0) | 2 (33.3) | 0.19 |
Etiology
| ||||
Ischemic
| 23 (100) | 8 (80.0) | 1 (16.7) | <0.001 |
Non-ischemic
| 0 | 2 (20.0) | 5 (83.3) | <0.001 |
Echocardiographic data
| ||||
MR grade
| 2.6 ± 0.6 | 3.8 ± 0.4a
| 3.7 ± 0.5a
| <0.01 |
LVEDD (mm)
| 66.3 ± 6.4 | 70.4 ± 7.4 | 66.2 ± 3.6 | 0.24 |
LVESD (mm)
| 48.7 ± 12.0 | 61.2 ± 9.7a
| 57.3 ± 4.2 | <0.01 |
LVEF (%)
| 40.4 ± 11.7 | 31.9 ± 5.4a
| 29.7 ± 7.4a
| 0.026 |
Serial echocardiographic evaluation of mitral valve function during systole and diastole
RMAP | Posterior PMR | Anterior PMR | P-value | |
---|---|---|---|---|
Preoperative
| ||||
MR grade
| 2.6 ± 0.6 | 3.8 ± 0.4a
| 3.7 ± 0.5a
| <0.01 |
CD (cm)
| 0.8 ± 0.2 | 1.4 ± 0.5a
| 1.1 ± 0.1 | <0.01 |
Tethering area (cm
2
)
| 1.5 ± 0.5 | 2.4 ± 0.6a
| 1.9 ± 0.5 | <0.01 |
MIA (°)
| 68 ± 8 | 61 ± 6 | 68 ± 7 | 0.076 |
α1 (°)
| 54 ± 10 | 49 ± 9 | 55 ± 6 | 0.32 |
α2 (°)
| 84 ± 17 | 83 ± 13 | 83 ± 9 | 0.99 |
L1 (cm)
| 1.8 ± 0.4 | 1.8 ± 0.4 | 1.8 ± 0.1 | 0.98 |
Postoperative
| ||||
MR grade
| 0.4 ± 0.6** | 0.5 ± 0.5** | 0.5 ± 0.5** | 0.25 |
CD (cm)
| 0.4 ± 0.2** | 0.4 ± 0.1** | 0.5 ± 0.3** | 0.59 |
Tethering area (cm
2
)
| 0.6 ± 0.5* | 0.4 ± 0.2* | 0.7 ± 0.4* | 0.41 |
MIA (°)
| 60 ± 9* | 42 ± 10a,c,** | 67 ± 6 | <0.01 |
α1 (°)
| 55 ± 12 | 39 ± 9a,c,* | 67 ± 12* | <0.01 |
α2 (°)
| 100 ± 12* | 106 ± 22* | 85 ± 10b
| 0.045 |
L1 (cm)
| 1.4 ± 0.3* | 1.1 ± 0.2a,* | 1.3 ± 0.1* | 0.012 |
Follow-up
| ||||
MR grade
| 0.6 ± 0.6** | 0.7 ± 0.4** | 0.5 ± 0.4** | 0.62 |
CD (cm)
| 0.5 ± 0.2** | 0.5 ± 0.3** | 0.5 ± 0.3** | 0.74 |
Tethering area (cm
2
)
| 0.8 ± 0.5* | 0.5 ± 0.3* | 0.7 ± 0.4* | 0.21 |
MIA (°)
| 62 ± 9* | 43 ± 10a,c,** | 69 ± 4 | <0.01 |
α1 (°)
| 55 ± 11 | 40 ± 9a,c,* | 67 ± 15* | <0.01 |
α2 (°)
| 101 ± 11* | 107 ± 16* | 85 ± 12a,b
| 0.013 |
L1 (cm)
| 1.4 ± 0.3* | 1.1 ± 0.1a,* | 1.3 ± 0.1* | 0.017 |