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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
08:31

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

Mitral valve abnormalities in hypertrophic cardiomyopathy: echocardiographic features and surgical outcomes

Ryan K Kaple1, Ross T Murphy, Linda M DiPaola

  • 1Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic, Cleveland, Ohio 44195, USA.

The Annals of Thoracic Surgery
|April 30, 2008
PubMed

Insights

Mitral valve (MV) abnormalities are common in hypertrophic cardiomyopathy (HCM). Echocardiography can predict successful MV repair, which is durable but feasible in only about half of HCM patients.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Imaging

Background:

  • Mitral valve (MV) abnormalities are frequent in hypertrophic cardiomyopathy (HCM).
  • Surgical indications for MV intervention in HCM are not fully defined.
  • This study investigates echocardiographic predictors of MV repairability and outcomes in HCM.

Purpose of the Study:

  • To define echocardiographic features of MV pathology in HCM patients.
  • To correlate these features with MV repairability, procedures, durability, and survival.
  • To identify predictors of successful mitral valve repair in HCM.

Main Methods:

  • Analysis of 784 echocardiograms from 115 HCM patients undergoing MV procedures (1986-2003).
  • Detailed assessment of MV morphology and associated pathologies.
  • Outcomes evaluated via cross-sectional follow-up.

Main Results:

  • 67 patients (58%) had MV repair, 48 (42%) had MV replacement.
  • Long leaflets and degenerative pathology predicted successful repair.
  • The anterior mitral leaflet was significantly longer in the repair group (3.0 cm vs 2.5 cm).
  • 91% of repaired patients were free of reoperation by 3 years.

Conclusions:

  • Intrinsic MV pathology is common in symptomatic HCM patients undergoing myectomy.
  • Echocardiography identifies features predictive of successful MV repair.
  • MV repair is durable but feasible in approximately 50% of HCM patients.
Abstract

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