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Long-term outcomes of papillary muscle relocation anteriorly for functional mitral regurgitation.
Oi, Keiji; Arai, Hirokuni; Nagaoka, Eiki; Fujiwara, Tatsuki; Oishi, Kiyotoshi; Takeshita, Masashi; Anzai, Tatsuhiko; Mizuno, Tomohiro.
Afiliación
  • Oi K; Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
  • Arai H; Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
  • Nagaoka E; Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
  • Fujiwara T; Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
  • Oishi K; Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
  • Takeshita M; Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
  • Anzai T; Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan.
  • Mizuno T; Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
Interact Cardiovasc Thorac Surg ; 35(6)2022 11 08.
Article en En | MEDLINE | ID: mdl-36130272
OBJECTIVES: This study aimed to evaluate the outcomes of the patients who underwent restrictive annuloplasty (RA) plus papillary muscle relocation anteriorly (PMR-A) with the risk factors in mitral valve repair for functional mitral regurgitation (FMR). METHODS: Eighty-six patients underwent mitral valve repair with RA for FMR. Thirty-five of them received additional bilateral papillary muscle relocation for severe leaflet tethering. The papillary muscles were relocated posteriorly (PMR-P) early in the study. Then, in the later period, the technique was modified to PMR-A, in which the papillary muscles were relocated anteriorly for 24 cases. The survival of the patients undergoing RA + PMR-A was examined retrospectively, adjusting for differences in patient background. RESULTS: Twenty-three deaths were observed during the follow-up period out of the 86 cases. Independent preoperative risk factors for survival were left ventricular ejection fraction, patient age and B-type natriuretic peptide (BNP) level. Among the patients with BNP <1000 pg/ml, 5-year survival after RA plus PMR-A was 84.7%, while RA alone was 78.6% and RA + PMR-P 57.1%. Cox proportional hazards regression adjusted for the preoperative risk factors showed a significantly higher hazard ratio of RA + PMR-P to RA + PMR-A (12.77, P = 0.011), while the hazard ratio of RA alone to RA + PMR-A was not significantly different. Furthermore, reverse remodelling of the left ventricle was observed for 3 years only in RA + PMR-A. CONCLUSIONS: Long-term survival for patients who underwent RA plus bilateral PMR-A was promising. Patients with significantly higher BNP had lower survival after valve repair for FMR.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Músculos Papilares / Función Ventricular Izquierda Tipo de estudio: Risk_factors_studies Límite: Humans Idioma: En Revista: Interact Cardiovasc Thorac Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Músculos Papilares / Función Ventricular Izquierda Tipo de estudio: Risk_factors_studies Límite: Humans Idioma: En Revista: Interact Cardiovasc Thorac Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido