Predictive value of less than moderate residual mitral regurgitation as assessed by transesophageal echocardiography for the short-term outcomes of patients with mitral regurgitation treated with mitral valve repair

Antonio Rizza,Sergio Berti,Laureta Sulcaj,Giuseppe Trianni,Cataldo Palmieri,Stefano Maffei,Massimiliano Mariani,Mattia Glauber

doi:10.1186/1476-7120-5-25

Antonio Rizza, Sergio Berti + Show 6 more

Open Access

https://doi.org/10.1186/1476-7120-5-25

Copy DOI

Journal: Cardiovascular Ultrasound	Publication Date: Jul 20, 2007
Citations: 33	License type: CC BY 2.0

Affiliation: Istituto di Fisiologia Clinica

Abstract

BackgroundTraditionally, in patients with mitral regurgitation (MR) a successful mitral valve repair is considered when residual MR by post-pump transesophageal echocardiography (TEE) is less than moderate or absent. Little is known about the prognostic value of less than moderate (mild or mild-to-moderate) residual MR for the early outcome of patients treated with mitral valve repair.MethodsEligible for this study were patients undergoing isolated mitral valve repair. Patients with moderate or severe residual MR after valve repair were excluded. The primary endpoint of the study was the composite of death or need of reintervention.ResultsA total of 98 patients (54 with no residual MR-Group 1, and 44 with less than moderate residual MR-Group 2) were analyzed. Of these, 72% presented with New York Heart Association (NYHA) 3/4, and 38% were women. The primary endpoint of the study occurred in 3 (5.5%) patients in Group 1 and 6 (13.6%) patients in Group 2 MR (P = 0.31). There was a trend toward a higher incidence of use of inotropic drugs post-interventional (P = 0.12), and a longer hospital stay among patients with less than moderate residual MR (P = 0.18).ConclusionIn our study population, patients with less than moderate residual MR had a trend toward a higher risk of early adverse outcomes as compared with patients with no residual MR by post-pump TEE. Studies with a larger patient population and longer follow-up data may be useful to better define the clinical significance of residual mild MR after mitral vale repair.

Highlights

In patients with mitral regurgitation (MR) a successful mitral valve repair is considered when residual MR by post-pump transesophageal echocardiography (TEE) is less than moderate or absent
It is important to note that mitral regurgitation changed in the last decades with regard to its etiologic profile, which is dominated by degenerative and ischemic causes in developed countries [3]; to its noninvasive assessment with the developments in transesophageal echocardiography (TEE), colour flow imaging, and new methods of quantization of regurgitation [1]; and to its management with improved understanding of the role of left ventricle (LV) function in prognosis [2]
In this study we evaluated the prognostic value for the early adverse outcomes of mild residual MR, as assessed

Summary

Introduction

In patients with mitral regurgitation (MR) a successful mitral valve repair is considered when residual MR by post-pump transesophageal echocardiography (TEE) is less than moderate or absent. Echo-Doppler grading of regurgitation severity in conjunction with patient symptoms and signs and occasionally invasive haemodynamic information are useful in the decision-making process with respect to the need for and timing of mitral valve surgery [2]. It is important to note that mitral regurgitation changed in the last decades with regard to its etiologic profile, which is dominated by degenerative and ischemic causes in developed countries [3]; to its noninvasive assessment with the developments in transesophageal echocardiography (TEE), colour flow imaging, and new methods of quantization of regurgitation [1]; and to its management with improved understanding of the role of left ventricle (LV) function in prognosis [2]. Advances in conservative surgery have improved its treatment [4]

Methods

Results

Conclusion