The mechanisms of ischemic mitral insufficiency
Abstract
In National Institute of Cardiovascular surgery NM Amosov in the period from 1 January 2012 to 31 December 2014 was performed 142 interventions on the mitral valve in patients with coronary heart disease and ischemic mitral regurgitation.
The average patient age was 61.8±7.4 years. The majority of patients with coronary artery disease and comorbid medical devices marked complicated background. Hypertensive heart disease was diagnosed in 59,9% (n=85) of patients, with diabetes mellitus – 14,8% (n=21), peripheral arterial disease – in 16,2% (n=23), acute cerebrovascular accident in history – in 3,5% (n=5).
Plastic surgery were performed in 93 (65.5%) patients, mitral valve replacement – in 49 (34.5%).
The development of mitral insufficiency is dependent upon the nature of left ventricular remodeling. Selection of surgical treatment depends on the anatomic changes of the valve unit and the geometry of the left ventricle.
References
2. Kusunose K., Kwon D. H., Motoki H., Flamm S. D., Marwick T. H. Comparison of three-dimensional echocardiographic findings to those of magnetic resonance imaging for determination of left ventricular mass in patients with ischemic and non-ischemic cardiomyopathy // Am J Cardiol. – 2013. – Vol. 112. – P. 604–611.
3. Goldstein D., Moskowitz A. J., Gelijns A. C., et al. Two-year outcomes of surgical treatment of severe ischemic mitral regurgitation // N Engl J Med. – 2016. – Vol. 374. – P. 344–353.
4. Functional capacity late after partial left ventriculectomy: relation to ventricular geometry and performance / Popovic Z., Miric M., Neskovic A. N., Vasiljevic J., Otasevic P., Zarkovic M. et al. // Eur J Cardio-thorac Surg. – 2001. – Vol. 19. – P. 61–67.
5. Nishimura R. A., Otto C. M., Bonow R. O., Carabello B. A., Erwin J. P. ІІІ., Guyton R. A., O’Gara P. T., Ruiz C. E., Skubas N. J., Sorajja P., Sundt T. M. III., Thomas J. D.; ACC/AHA Task Force Members. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines // Circulation. – 2014. – Vol. 129. – P. 2440–2492.
6. The Euro Heart Failure survey programme a survey on the quality of care among patients with heart failure in Europe / Clenand J., Swedberg K., Follath F. // Eur Heart J. – 2007. – Vol. 24 (5). – P. 442–463.
7. Surgical left ventricle reconstruction, pathophysiologic insight, results and expectation from the STICH trial / Menicanti L., M. Di Donato // Eur J Cardio-thorac Surg. – 2004. – Vol. 26. – P. 42–47.
8. Kwon D. H., Hachamovitch R., Popovic Z. B., Starling R. C., Desai M. Y., Flamm S. D., Lytle B. W., Marwick T. H. Survival in patients with severe ischemic cardiomyopathy undergoing revascularization versus medical therapy: association with end-systolic volume and viability // Circulation. – 2012. – Vol. 126. – P. S3–S8.
9. Meris A., Amigoni M., Verma A., Thune J. J., Kшber L., Velazquez E., McMurray J. J., Pfeffer M. A., Califf R., Levine R. A., Solomon S. D. Valsartan in Acute Myocardial Infarction (VALIANT) Investigators. Mechanisms and predictors of mitral regurgitation after high-risk myocardial infarction // J Am Soc Echocardiogr. – 2012. – Vol. 25. – P. 535–542.