555 Mitral Regurgitation Lesion Type Impacts Outcomes Following Mitral Valve Repair in Patients With Non-Ischemic Cardiomyopathy and Severe Left Ventricle Dysfunction

Abstract

mmHg for band patients and 5.8 / 2.6 mmHg for ring (P .0001). Mean mitral valve area at rest was 2.3 / 0.6 cm for band and 1.8 / 0.5 cm for ring (P .0001). Exercise duration was 12.9 / 5.7 min for band and 12.6 / 5.7 min for ring (P .78); distance covered was respectively 471 / 77 m for band and 443 / 107 m for ring (P .12). At peak exercise, mean mitral gradient was 10.6 / 4.8 mmHg for band vs 15.3 / 8.2 mmHg for ring (P .0002) while RVSP was respectively 45.8 / 9.5 mmHg for band and 52.6 / 14.2 mmHg for ring (P .004). FMS was present in 17% of band patients vs 55% of ring patients (P .0001). Congestive heart failure (P .05) and atrial fibrillation (P .006) were associated with the utilization of a ring annuloplasty; in addition, ring patients reported lower levels of energy (P .02) and general health (P .007) on their SF-36. Predictors of FMS included ring usage (OR 3.8, 1.3-11.8), smaller resting mitral valve area (OR 9.2, 2.5-33.3) and younger patients (OR 6.9, 2.3-21.5). CONCLUSION: In this first study using full echocardiographic and functional assessment of patients with degenerative mitral valve disease following mitral valve repair, the utilization of a mitral ring was associated with functional mitral stenosis, recurrence of CHF and markers of poorer quality of life. In light of these findings, we have adjusted our techniques and would recommend that careful consideration be given to the selection of an annuloplasty device at the time of mitral valve repair.