Predictors of failure following restrictive annuloplasty for chronic ischemic mitral regurgitation

J Card Surg. 2012 Jan;27(1):6-12. doi: 10.1111/j.1540-8191.2011.01342.x. Epub 2011 Nov 11.

Abstract

Aim of the study: We sought to determine the results of restrictive annuloplasty for chronic ischemic mitral regurgitation.

Methods: Hospital outcome and serial clinical and echocardiographic (preoperative, discharge, 3 months, 12 months, 24 months) follow-up assessments were analyzed in 87 consecutive patients with chronic ischemic mitral regurgitation having coronary artery bypass grafting. Persistent/recurrent mitral regurgitation was defined by grade ≥2 at discharge/during follow-up.

Results: Hospital mortality was 5.7% and persistence of regurgitation was present in 8.4%. Mean follow-up was 24.4 ± 1.7 months and recurrent mitral regurgitation was observed in 32.4% patients. In multivariate analysis only anterior leaflet angle remained an independent predictive factor for regurgitation recurrence with cutoff 27° (sensitivity of 67% and specificity of 76%, p = 0.04).

Conclusion: There is high occurrence of early and delayed restrictive annuloplasty failure, particularly in patients with increased anterior leaflet tethering.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Coronary Artery Bypass
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / surgery
  • Echocardiography, Doppler
  • Echocardiography, Transesophageal
  • Female
  • Follow-Up Studies
  • Hospital Mortality
  • Humans
  • Logistic Models
  • Male
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / pathology
  • Mitral Valve / surgery
  • Mitral Valve Annuloplasty*
  • Mitral Valve Insufficiency / complications
  • Mitral Valve Insufficiency / diagnostic imaging
  • Mitral Valve Insufficiency / mortality
  • Mitral Valve Insufficiency / surgery*
  • Multivariate Analysis
  • Recurrence
  • Treatment Failure