Ischemic mitral regurgitation, mechanisms of the development and evaluation of its surgical correction
Abstract
Ischemic mitral regurgitation (IMR) is a frequent complication of myocardial infarction, which negatively affects the functional state of the cardiovascular system and mortality. The paper presents the mechanisms of IMR development and analysis of suture annuloplasty of mitral valve and ring annuloplasty of mitral valve in patients with coronary artery disease and IMR. The direct results of mitral valve ring annuloplasty and suture annuloplasty of mitral valve in patients with coronary artery disease and concomitant IMR are good. There was no detected statistically significant difference between the two methods of mitral valve annuloplasty in this study. The clinical condition of the patients improved significantly, reflecting the positive impact of ring annuloplasty and suture annuloplasty on the quality of life in patients with coronary artery disease and IMR. However, in order to determine clear indications to the particular method of correction of ischemic mitral regurgitation, there is a need in longer follow-up with larger group of patients in the late postoperative period.
References
2. Chan J. et al. Coronary Artery Bypass Surgery With or Without Mitral Valve Annuloplasty in Moderate Functional Ischemic Mitral Regurgitation Final Results of the Randomized Ischemic Mitral Evaluation (RIME) Trial // Circulation. – 2012. – Nov 2. – Vol. 126 (21). – P. 2502–10.
3. Czer L. S., Maurer G., Bolger A. F. et al. Revascularization alone or combined with suture annuloplasty for ischemic mitral regurgitation: evalua tion by color Doppler echocardiography // Tex Heart Inst J. – 1996. – Vol. 23. – Р. 270–278.
4. Dudzinski D. et al. Echocardiographic assessment of ischemic mitral regurgitation // Cardiovascular Ultrasound. – 2014. – Vol. 12. – P. 46.
5. Hung J. et al. Mechanism of recurrent ischemic mitral regurgitation after annuloplasty: continued LV remodeling as a moving target // Circulation. – 2004. – Sep 14, 11 0 (11 Suppl 1). – II85–90.
6. Idoski Enver et al. Reverse left ventricular remodelling after surgical correction of ischaemic mitral regurgitation // Cardiologia Croatica. – 2013. – Vol. 8, Issue 5/6. – P. 198.
7. Pierard L. A., Carabello et al. Ischaemic mitral regurgitation: pathophysiology, outcomes and the conundrum of treatment // European Heart Journal. – 2010. – Vol. 31, issue 24. – P. 2996–3005.
8. Rankin J. et al. Mitral valve repair for ischemic mitral regurgitation: review of current techniques // Heart, Lung and Vessels. – 2013. – Vol. 5 (4). – P. 246–251.
9. Traves D. Crabtree et al. Recurrent Mitral Regurgitation and Risk Factors for Early and Late Mortality After Mitral Valve Repair for Functional Ischemic Mitral Regurgitation // The Annals of Thoracic Surgery. – 2008. – Vol. 85, issue 5, P. 1537–1543.