Efficacy of left atrial plication for atrial functional mitral regurgitation
- PDF / 1,215,929 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 9 Downloads / 219 Views
ORIGINAL ARTICLE
Efficacy of left atrial plication for atrial functional mitral regurgitation Masamichi Matsumori1 · Motoharu Kawashima1 · Takamitsu Aihara1 · Jun Fujisue1 · Masato Fujimoto1 · Keigo Fukase1 · Yoshikatsu Nomura1 · Hiroshi Tanaka1 · Hirohisa Murakami1 · Nobuhiko Mukohara1 Received: 22 March 2020 / Accepted: 16 August 2020 © The Author(s) 2020
Abstract Objective Atrial functional mitral regurgitation (AFMR) is caused by atrial fibrillation and left atrial enlargement. Our study aimed to evaluate the efficacy of left atrial plication (LAP) for AFMR. Methods Of 1164 mitral valve surgery patients at our hospital from January 2000 to May 2019, 22 patients underwent surgery for AFMR. Our retrospective analysis divided the patients with AFMR into two groups according to whether LAP was performed (LAP + group, n = 9; LAP − group, n = 13). Mitral valve angle (MV angle) (horizontal inclination of mitral valve) was measured by pre- and post-operative computed tomography scan. Individuals with type II mitral regurgitation, left ventricular ejection fraction of 60 mm and females with > 55 mm, aortic valve disease, mitral valve calcification, hypertrophic obstructive cardiomyopathy, and both “redo” and emergency cases were excluded. Result Mitral valve replacement was performed in 6 patients and mitral ring annuloplasty in 16 cases. No recurrence of mitral regurgitation or structural valve deterioration occurred during the follow-up period. There were no hospital deaths; 3 deaths occurred during the follow-up period. Compared to the LAP − group, the LAP + group demonstrated a significantly greater decrease of MV angle (16.6 ± 8.1° vs. 1.2 ± 6.9°, p 40 mm). Patients with functional MR (LV dysfunction), aortic valve disease, redo cases, and emergency cases were excluded from the analysis. We divided into two
13
Vol.:(0123456789)
General Thoracic and Cardiovascular Surgery
groups according to perform LAP: LAP + group consist of 9 patients who was performed LAP and LAP − group consist of 13 patients who was not performed LAP (Fig. 1). Preoperative patient characteristics are given in Table 1. Mean age was 73.5 ± 5.7 (61–83) years, and mean body surface area was 1.54 ± 0.38 (1.35–1.94) m2. 7 patients (31.8%) were NHYA (New York Heart Association) functional class greater than III. Patient permission with informed consent was obtained for retrospectively analyzing and reporting these results.
The report was reviewed and approved by the Institutional Review Board of Hyogo Brain and Heart Center at Himeji.
Echocardiography All patients underwent preoperative transthoracic echocardiography (TTE) (Table 2). From the parasternal longaxis window, we measured left ventricular end-diastolic dimension (LVDd), left ventricular end-systolic dimension (LVDs), and LA dimension (LAD). MR regurgitant volume (RV) and effective regurgitant orifice area (EROA) were calculated for quantification of MR. Post-operative TTE was performed 7–10 days after surgery. After 2011, in 13 of 22 patients, we also measured anterior mi
Data Loading...
