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Transient late-onset ischemic mitral regurgitation following Dor's procedure

Kenichi Nakashiki1, Yutaka Otsuji2, Takayuki Ueno3

  • 1Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan. kenichi_nakashiki@mac.com.

Journal of Echocardiography
|June 10, 2016
PubMed

Insights

Late-onset mitral regurgitation after Dor's procedure can resolve spontaneously with medication. Full recovery may take over four months, suggesting conservative management before surgical intervention.

Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • A 60-year-old male experienced anteroseptal myocardial infarction and left hemiplegia.
  • Echocardiography revealed an apical aneurysm with thrombus, leading to coronary artery bypass grafting and Dor's procedure.
  • Post-surgery, the patient developed chronic heart failure (CHF) with mitral regurgitation (MR).

Purpose of the Study:

  • To investigate the natural course of late-onset mitral regurgitation following Dor's procedure.
  • To evaluate the efficacy of conservative management for transient MR post-cardiac surgery.

Main Methods:

  • Case report detailing a patient's cardiac event and surgical history.
  • Clinical observation of CHF and MR development and resolution.
  • Echocardiographic assessment of cardiac function and valve status.

Main Results:

  • Chronic heart failure with mitral regurgitation manifested three months post-Dor's procedure.
  • The mitral regurgitation resolved spontaneously over two months with continued medical management.
  • Full resolution of MR was observed after approximately four months of conservative treatment.

Conclusions:

  • Late-onset mitral regurgitation after Dor's procedure can be transient.
  • Conservative management with medication may lead to the resolution of MR, potentially avoiding surgical intervention.
  • A treatment window of four or more months is crucial to assess the full effects of medication before considering surgery for late MR post-Dor's procedure.

Keywords:
Chronic heart failureIschemic heart diseaseLeft ventricular plastyMitral valve

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