Stress echocardiographic assessment of mitral valve function repaired using rough-zone trimming

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• 作者：Yohsuke Yanase ; Nobuyuki Takagi ; Hiroyuki Yamada…
• 关键词：Mitral regurgitation ; Mitral valve repair ; Echocardiography ; Heart valve ; Surgery techniques
• 刊名：Journal of Cardiothoracic Surgery
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：10
• 期：1
• 全文大小：2,565 KB
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• 刊物主题：Cardiac Surgery; Thoracic Surgery;
• 出版者：BioMed Central
• ISSN：1749-8090

文摘

Background We invented novel mitral valve repair technique; rough-zone trimming procedure (RZT) for anterior mitral valve prolapse. Prolapse site was resected in obtuse triangle shape and sutured edges to creates deep coaptation and improves regurgitation. Though it is simple and reproducible technique, functional mitral stenosis is a risk. Valve function and hemodynamics were investigated using dobutamine stress echocardiography (DSE) in patients after mitral valve repair using RZT. Methods Patients underwent RZT for the anterior mitral valve (AML, n--0), quadrangular resection (QR) of the posterior mitral valve (PML; n--), RZT-?QR of bileaflet valves (bileaflet; n--) and healthy individuals (control; n--0) and were assessed by DSE (doses up to 20?μg/Kg/min). Echocardiographic data including mitral valve area (MVA), mitral valve mean pressure gradient (MVmeanPG), and systolic pulmonary artery pressure (sPAP) were measured at rest and at peak stress. Results Rest/stress MVA (cm2), MVmeanPG (mmHg) and sPAP (mmHg) were 2.8?±-.4 and 3.4?±-.3, 3.3?±-.1 and 7.4?±-.1, and 25.7?±-.7and 49.1?±-.1, respectively, in the AML group. Dobutamine stress increased all parameters but not to pathological levels. The results were similar to those of the other groups after mitral valve repair, whereas MVA was larger and MVmeanPG was lower in the control than in the AML group. Conclusions Valve repair using RZT does not pathologically obstruct the mitral valve, either at baseline or during dobutamine stress, and does not affect valve hemodynamics and reserve.