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Updated: May 27, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
[Surgical strategy for mitral regurgitation in ischemic cardiomyopathy]
Shinichi Mizutani1, Akihiko Usui, Hideki Oshima
1Department of Cardio-thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Objective:
Surgical strategy for the mitral regurgitation (MR) in patients with ischemic cardiomyopathy (ICM) still remains controversial. The purpose of this study is to evaluate the operative outcome and long-term survival in patients with ICM, MR.
Methods:
Perioperative data and surgical results of 35 patients with ischemic MR were collected. Mitral annuloplasty with artificial ring (MAP) was performed in 27 patients and mitral valve replacement (MVR) in 8 patients. Preoperative left ventricular ejection fraction (LVEF) in MVR was significantly lower (23.1 +/- 11.8 : 33.4 +/- 10.3%, p < 0.05) and the left ventricular diastolic dimension (LVDd) was dilated (73.7 +/- 9.3: 64.2 +/- 7.0 mm, p < 0.01). Concomitant procedures including coronary artery bypass grafting and/or left ventricular reconstruction were performed in more than half patients.
Results:
No operative death was observed in both groups. Postoperative data showed that MVR still remained in low left ventricular (LV) function. Six of 27 patients in MAP developed more than grade 2 MR during follow up period and 1 required reoperation. No significant difference was observed in survival and in freedom rate from cardiac event between groups.
Conclusions:
MAP had no impact on operative outcome and long-term survival in patients with ICM, MR. MVR should be considered in patients with severely impaired LV function to avoid the risk of recurrence of MR.
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