Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2010, 154(2):141-145 | DOI: 10.5507/bp.2010.021

PERSISTENT AND RECURRENT ISCHEMIC MITRAL REGURGITATION

Martin Troubil, Vladimir Lonsky, Marek Gwozdziewicz, Vilem Bruk
Cardiac Surgery Department, University Hospital Olomouc, Czech Republic

Backround. Ischemic mitral regurgitation (IMR) is a consequence of coronary artery disease and the main underlying mechanism is augmented leaflet tethering due to outward displacement of the papillary muscles. Although mitral annuloplasty combined with coronary revascularization is usually effective in the treatment of IMR, occasionally the regurgitation can persist or recur and this can affect patient prognosis.

Methods: We searched Medline and Google scholar database for articles published since 1996 to June 2009. Search terms included ischemic mitral regurgitation, recurrent mitral regurgitation, persistent mitral regurgitation and annuloplasty failure.

Conclusion: This article reviews current knowledge about IMR, the reasons and mechanisms of persistent and recurrent mitral regurgitation. We review clinic and echocardiographic predictive factors associated with persistence a recurrence of mitral regurgitation after annuloplasty.

Keywords: Ischemic mitral regurgitation, Recurrent mitral regurgitation, Persistent mitral regurgitation, Annuloplasty failure

Received: December 1, 2009; Accepted: April 27, 2010; Published: June 1, 2010  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Troubil, M., Lonsky, V., Gwozdziewicz, M., & Bruk, V. (2010). PERSISTENT AND RECURRENT ISCHEMIC MITRAL REGURGITATION. Biomedical papers154(2), 141-145. doi: 10.5507/bp.2010.021
Download citation

References

  1. Komeda M, Kitamura H, Fukaya S. Surgical Treatment for Functional Mitral Regurgitation. Circ J 2009; 73: A23-A28. Go to original source... Go to PubMed...
  2. Lamas G, Mitchell G, Flaker G, Smith S, Gersh B, Basta L et al. Clinical significance of mitral regurgitation after acute myocardial infarction. Circulation 1997; 96:827833. Go to original source... Go to PubMed...
  3. Grigioni F, Enriquez-Sarano M, Zehr KJ, Bailey KR, Tajik AJ. Ischemic mitral regurgitation. Long-term outcome and prognostic implications with quantitative Doppler assessment. Circulation 2001; 103:17591764. Go to original source... Go to PubMed...
  4. Otsuji Y, Handschumacher MD, Jiang L, Song JK, Guerrero JL, Vlahakes GJ, Levine RA. Insights from three-dimensional echocardiography into the mechanism of functional mitral regurgitation: direct in vivo demonstration of altered leaflet tethering geometry. Circulation 1997; 96:19992008. Go to original source... Go to PubMed...
  5. Robert A. Levine and Ehud Schwammenthal: Ischemic Mitral Regurgitation on the Threshold of a Solution: From Paradoxes to Unifying Concepts. Circulation 2005; 112:745758. Go to original source...
  6. Bax JJ, Braun J, Somer ST, Klautz R, Holman ER, Versteegh MI, Boersma E, Schalij MJ, van der Wall EE, Dion RA. Restrictive annuloplasty and coronary revascularization in ischemic mitral regurgitation results in reverse left ventricular remodelling. Circulation 2004; 110(suppl II):II-103-II-108. Go to original source...
  7. Lachmann J, Shirani J, Plestis KA, Frater RW, LeJemtel TH. Mitral ring annuloplasty: an incomplete correction of functional mitral regurgitation associated with left ventricular remodelling. Curr Cardiol Rep 2001; 3:241246. Go to original source... Go to PubMed...
  8. McGee EC, Gillinov AM, Blackstone EH, Rajeswaran J, Cohen G, Najam F, Shiota T, Sabik JF, Lytle BW, McCarthy PM, Cosgrove DM. Recurrent mitral regurgitation after annuloplasty for functional ischemic mitral regurgitation. J Thorac Cardiovasc Surg 2004; 128:916 924. Go to original source... Go to PubMed...
  9. Burch GE, De Pasquale NP, Phillips JH. Clinical manifestations of papillary muscle dysfunction. Arch Intern Med 1963; 112:112 117. Go to original source... Go to PubMed...
  10. Boltwood CM, Tei C, Wong M, Shah PM. Quantitative echocardiography of the mitral complex in dilated cardiomyopathy: the mechanism of functional mitral regurgitation. Circulation 1983; 68:498508. Go to original source... Go to PubMed...
  11. Otsuji Y, Levine RA, Takeuchi M, Sakata R, Tei C. Mechanism of ischemic mitral regurgitation. J Cardiol 2008; 51(3):145. Go to original source... Go to PubMed...
  12. Kono T, Sabbah NH, Rosman H, et al. Left ventricular shape is the primary determinant of functional mitral regurgitation in heart failure. J Am Coll Cardiol 1992; 20:15941598. Go to original source... Go to PubMed...
  13. Komeda M, Glasson JR, Bolger AF, Daughters GT, Maclsaac A, Osterle SN, Ingels NB Jr, Miller DC. Geometric determinants of ischemic mitral regurgitation. Circulation 1997; 96(suppl II):II-128II-133.
  14. He S, Fontaine A, Schwammental E, Yoganathan A, Levine RA. Integrated mechanism for functional mitral regurgitation. Leaflet restriction versus coapting force: in vitro studies. Circulation 1997; 96:18261834. Go to original source... Go to PubMed...
  15. Otsuji Y, Handschumacher MD, Schwammenthal E, et al. Insights from three-dimensional echocardiography into the mechanism of functional mitral regurgitation. Direct in vivo demonstration of altered leaflet tethering geometry. Circulation 1997; 96:19992008. Go to original source... Go to PubMed...
  16. Otsuji Y, Handschumacher MD, Liel-Cohen N, Tanabe H, Jiang L, Schwammenthal E, Guerrero JL, Nicholls LA, Vlahakes GJ, Levine RA. Mechanism of ischemic mitral regurgitation with segmental left ventricular dysfunction: Three-dimensional echocardiographic studies in models of acute and chronic progressive regurgitation. J Am Coll Cardiol 2001; 37:641648. Go to original source... Go to PubMed...
  17. Aklog L, Filsoufi F, Flores KQ, Chen RH, Cohn LH, Nathan NS, et al. Does coronary artery bypass grafting alone correct moderate ischemic mitral regurgitation? Circulation 2001; 104:I6875. Go to original source... Go to PubMed...
  18. Mallidi HR, Pelletier MP, Lamb J, Desai N, Sever J, Christakis GT et al. Late outcomes in patients with uncorrected mild to moderate mitral regurgitation at the time of isolated coronary artery bypass grafting. J Thorac Cardiovasc Surg 2004; 127:63644. Go to original source... Go to PubMed...
  19. Kim YH, Czer LS, Soukiasian HJ, De Robertis M, Magliato KE, Blanche C, et al. Ischemic mitral regurgitation: revascularization alone versus revascularization and mitral valve repair. Ann Thorac Surg 2005; 79:1895901. Go to original source... Go to PubMed...
  20. Borger MA, Alam A, Murphy PM, Doenst T, David TE. Chronic ischemic mitral regurgitation: repair, replace or rethink? Ann Thorac Surg 2006; 81:115361. Go to original source... Go to PubMed...
  21. Agricola E, Oppizzi M, Pisani M, Meris A, Maisano F, Margonato A. Ischemic mitral regurgitation: mechanisms and echocardiographic classification . Eur J Echocardiogr; 9:207221.
  22. Bolling SF, Pagani FD, Deeb GM, Bach DS. Intermediateterm outcome of mitral reconstruction in cardiomyopathy. J Thorac Cardiovasc Surg 1998; 115:3816. Go to original source... Go to PubMed...
  23. Braun J, Bax JJ, Versteegh MI, Voigt PG, Holman ER, Klautz RJ, et al. Preoperative left ventricular dimensions predict reverse remodelling following restrictive mitral annuloplasty in ischemic mitral regurgitation. Eur J Cardiothorac Surg 2005; 27:84753. Go to original source... Go to PubMed...
  24. Zhu F, Otsuji Y, Yotsumoto G, Yuasa T, Ueno T, Yu B,et al. Mechanism of persistent ischemic mitral regurgitation after annuloplasty: mportance of augmented posterior mitral leaflet tethering. Circulation 2005; 112:I-396 I-401. Go to original source...
  25. Gelsomino S , Lorusso R, De Cicco G, Capecchi I, Rostagno C, et al. Five-year echocardiographic results of combined undersized mitral ring annuloplasty and coronary artery bypass grafting for chronic ischaemic mitral regurgitation. Eur Heart J 2008; 29:231 240. Go to original source... Go to PubMed...
  26. Serri K, Bouchard D, Demers P, Coutu M, Pellerin M, Carrier M, et al. Is a good perioperative echocardiographic result predictive of durability in ischemic mitral valve repair? J Thorac Cardiovasc Surg 2006; 131:56573. Go to original source... Go to PubMed...
  27. Magne J, Pibarot P, Dagenais F, Hachicha Z, Dumesnil JG, Senechal M. Preoperative posterior leaflet angle accurately predicts outcome after restrictive mitral valve annuloplasty for ischemic mitral regurgitation. Circulation 2007; 115:782791. Go to original source... Go to PubMed...
  28. Kuwahara E, Otsuji Y, Iguro Y, Ueno T, Zhu F, Mizukami N et al. Mechanism of Recurrent/Persistent Ischemic/Functional Mitral Regurgitation in the Chronic Phase After Surgical Annuloplasty: Importance of Augmented Posterior Leaflet Tethering. Circulation 2006; 114:I-529 - I-534. Go to original source... Go to PubMed...
  29. Hung J, Papakostas L, Tahta SA, Hardy BG, Bollen BA, Duran CM, et al. Mechanism of recurrent ischemic mitral regurgitation after annuloplasty: continued LV remodelling as a moving target. Circulation 2004; 110:II8590. Go to original source... Go to PubMed...
  30. Ereminiene E, Vaskelyte J, Benetis R, Stoskute N. Ischemic mitral valve repair: predictive significance of restrictive left ventricular diastolic filling. Echocardiography 2005; 22:21724. Go to original source... Go to PubMed...
  31. Kongsaerepong et al. Echocardiographic predictors of succesful versus unsuccesful mitral valve repair in ischemic mitral regurgitation. Am J Cardiol 2006; 98:504508. Go to original source... Go to PubMed...
  32. Calafiore A, Di Mauro M, Gallina S, Di Giammarco G, Iac G, Teodori G aet al. Mitral valve surgery for chronic ischemic mitral regurgitation Ann Thorac Surg 2004; 77:19891997. Go to original source... Go to PubMed...