TY - JOUR
T1 - Midterm outcomes of chordal cutting in combination with downsized ring annuloplasty for ischemic mitral regurgitation
AU - Murashita, Takashi
AU - Okada, Yukikatsu
AU - Kanemitsu, Hideo
AU - Fukunaga, Naoto
AU - Konishi, Yasunobu
AU - NaKamura, Ken
AU - Koyama, Tadaaki
N1 - Publisher Copyright:
© 2014 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery. All rights reserved.
PY - 2014
Y1 - 2014
N2 - Purpose: We describe midterm outcomes after division of secondary chords (chordal cutting)combined with downsized ring annuloplasty for ischemic mitral regurgitation (IMR).Methods: We compared the clinical outcomes in patients who underwent chordal cuttingwith downsized ring annuloplasty (CC-group, n = 15) and those who underwent conventionalring annuloplasty only (Conventional-group, n = 35) for IMR. Follow-up was complete inall patients. The median follow-up time was 4.1 years.Results: Thirty-day mortality was 0% in CC-group and 20% in Conventional-group. Theoverall survival rate at 5-year was 80.8% ± 12.6% in CC-group and 61.7% ± 8.4% inConventional-group (Log-rank, p = 0.145). The freedom rate from valve-related events at5 year was 84.6% ± 10.0% in CC-group and 65.3% ± 10.1% in Conventional-group (Logrank,p = 0.213). Recurrence of severe mitral regurgitation was revealed in 3 patients ofCC-group. Preoperative tenting height was the significant predictor of mitral regurgitationrecurrence. In CC-group, the mean left ventricular ejection fraction was 38.0% ± 14.0%,which was similar to the preoperative value of 40.0% ± 13.2% (p = 0.349).Conclusions: Chordal cutting with downsized ring annuloplasty for IMR is a simple methodand provides satisfactory early outcomes. However, it carries with high recurrence of MRespecially for patients with high tenting height.
AB - Purpose: We describe midterm outcomes after division of secondary chords (chordal cutting)combined with downsized ring annuloplasty for ischemic mitral regurgitation (IMR).Methods: We compared the clinical outcomes in patients who underwent chordal cuttingwith downsized ring annuloplasty (CC-group, n = 15) and those who underwent conventionalring annuloplasty only (Conventional-group, n = 35) for IMR. Follow-up was complete inall patients. The median follow-up time was 4.1 years.Results: Thirty-day mortality was 0% in CC-group and 20% in Conventional-group. Theoverall survival rate at 5-year was 80.8% ± 12.6% in CC-group and 61.7% ± 8.4% inConventional-group (Log-rank, p = 0.145). The freedom rate from valve-related events at5 year was 84.6% ± 10.0% in CC-group and 65.3% ± 10.1% in Conventional-group (Logrank,p = 0.213). Recurrence of severe mitral regurgitation was revealed in 3 patients ofCC-group. Preoperative tenting height was the significant predictor of mitral regurgitationrecurrence. In CC-group, the mean left ventricular ejection fraction was 38.0% ± 14.0%,which was similar to the preoperative value of 40.0% ± 13.2% (p = 0.349).Conclusions: Chordal cutting with downsized ring annuloplasty for IMR is a simple methodand provides satisfactory early outcomes. However, it carries with high recurrence of MRespecially for patients with high tenting height.
KW - Chordal cutting
KW - Ischemic mitral regurgitation
KW - Left ventricular function
KW - Ring annuloplasty
UR - http://www.scopus.com/inward/record.url?scp=84918817771&partnerID=8YFLogxK
U2 - 10.5761/atcs.oa.13-00293
DO - 10.5761/atcs.oa.13-00293
M3 - Article
C2 - 24492174
AN - SCOPUS:84918817771
SN - 1341-1098
VL - 20
SP - 1008
EP - 1015
JO - Annals of Thoracic and Cardiovascular Surgery
JF - Annals of Thoracic and Cardiovascular Surgery
IS - 6
ER -