Isolated Undersized Mitral Annuloplasty for Functional Mitral. Regurgitation in Non-Ischemic Dilated Cardiomyopathy : Reconsideration of the Relationship Between Preoperative Coaptation Depth and Persistent Mitral Regurgitation

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Background A preoperative coaptation depth (CD) ≥11mm is apparently a predictive factor for persistent mitral regurgitation (MR) after undersized mitral annuloplasty for functional MR. The results of studies of isolated undersized mitral annuloplasty in non-ischemic dilated cardiomyopathy (DCM) are reported, including the relationship between the preoperative CD and recurrent MR. Methods and Results Six patients (mean age, 61 years) with severe functional MR in non-ischemic DCM underwent isolated undersized mitral annuloplasty. There were no hospital deaths. At intermediate follow-up of 2.2±1.9 years, New York Heart Association functional class improved significantly from 3.3±0.5 before surgery to 2.2±0.4 after surgery (p=0.0016). At a mean echocardiographic follow-up of 1.9±1.7 years, MR grade improved significantly from 4.0±0.0 before surgery to 1.0±0.6 after surgery (p<0.001). In 4 of 5 patients with a preoperative CD ≥11mm, functional MR improved to mild or less than mild after surgery. Conclusions Isolated undersized mitral annuloplasty improved clinical symptoms and functional MR in non-ischemic DCM. These results suggest that preoperative CD ≥11mm does not always predict recurrent MR after isolated undersized mitral annuloplasty for functional MR in cases of non-ischemic DCM.
社団法人日本循環器学会の論文
2008-10-20