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Updated: May 8, 2026
08:31
A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
[Surgical ventricular restoration for functional mitral regurgitation]
Masaki Funamoto1, Kenji Minakata, Kazuhiro Yamazaki
1Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|August 30, 2013
Summary
Surgical ventricular restoration (SVR) improved leaflet tethering and mitral regurgitation in severe left ventricular dilatation. However, long-term outcomes were poor for patients requiring SVR, despite initial benefits.
Area of Science:
- Cardiovascular Surgery
- Cardiac Mechanics
- Mitral Valve Disease
Context:
- Functional mitral regurgitation (FMR) due to severe leaflet tethering presents a complex surgical challenge.
- Comparing outcomes of mitral annuloplasty (MAP) alone versus MAP with surgical ventricular restoration (SVR) for FMR.
- Preoperative assessment revealed group S (MAP + SVR) had lower ejection fraction, larger left ventricle, and more severe mitral regurgitation than group M (MAP alone).
Purpose:
- To evaluate the effectiveness and limitations of surgical ventricular restoration (SVR) in patients with functional mitral regurgitation (FMR) caused by severe leaflet tethering.
- To compare the short-term and long-term outcomes of mitral annuloplasty (MAP) alone versus MAP combined with SVR for FMR.
Summary:
- Surgical ventricular restoration (SVR) combined with mitral annuloplasty (MAP) significantly reduced leaflet tethering and mitral regurgitation (MR) in patients with severe left ventricular (LV) dilatation.
- While LV dimensions decreased and MR grade improved in both groups, SVR did not significantly improve ejection fraction.
- Hospital mortality was higher in the SVR group (18%) compared to the MAP-alone group (0%), and late deaths were also more frequent in the SVR group.
Impact:
- SVR effectively addresses leaflet tethering and MR in severe LV dilatation, offering a potential solution for complex FMR cases.
- The study highlights significant limitations in long-term outcomes for patients undergoing SVR, suggesting careful patient selection is crucial.
- Findings indicate that while SVR provides anatomical benefits, its impact on long-term survival in this patient cohort requires further investigation and may be suboptimal.
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