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Updated: Jun 1, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Management of mitral regurgitation during left ventricular reconstruction for ischemic heart failure
Patrick Klein1, Jerry Braun, Eduard R Holman
1Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands. p.klein@lumc.nl
Objective:
Remodeling of the left ventricle (LV) in ischemic cardiomyopathy frequently leads to functional mitral regurgitation (MR). The indication for correcting MR in patients undergoing LV reconstruction (LVR) is unclear. In this study, we evaluated our strategy of correcting MR≥grade 2+ by restrictive mitral annuloplasty (RMA) during LVR.
Methods:
We studied 92 consecutive patients (76 men, mean age 61±10 years) who underwent LVR for ischemic heart failure (IHF). RMA was performed in all patients with MR≥grade 2+ on preoperative echocardiography and in patients who showed increased MR to ≥grade 2+ immediately after LVR. Patients were attributed to a RMA and no-RMA group, depending on whether or not concomitant RMA had been performed. Mean clinical and structured echocardiographic follow-up was 47±20 months and was 100% complete.
Results:
In 38 out of 40 patients (95%) with preoperative MR≥grade 2+, concomitant RMA was planned and performed. In 17 out of 52 patients (33%) with MR
Conclusions:
Patients with IHF eligible for LV reconstruction have MR≥grade 2+ in 44% of cases. In one-third of IHF patients with MR
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