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Partial Annuloplasty Rings in the Repair of Functional Ischemic Mitral Regurgitation

Muhammad Aqeel Kunwar1, Imran Muhammad2, Muhammad N Khan3

  • 1Cardiac Surgery, National Heart Institute, Kuala Lumpur, MYS.

Cureus
|July 10, 2020
PubMed

Insights

Lifting posterior mitral annuloplasty (LPMA) is a successful surgical technique for treating ischemic mitral regurgitation (IMR) following myocardial infarction (MI). This procedure demonstrated a high immediate success rate in patients undergoing concomitant coronary artery bypass grafting (CABG).

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Cardiac Surgery Outcomes

Background:

  • Acute myocardial infarction (MI) is a primary cause of global cardiac morbidity and mortality.
  • Ischemic mitral regurgitation (IMR) is a frequent complication of MI, with variable clinical and hemodynamic severity.
  • Mitral valve (MV) repair using lifting annuloplasty is a surgical approach for IMR, but its immediate outcomes require evaluation.

Purpose of the Study:

  • To evaluate the immediate outcomes of mitral valve (MV) annuloplasty as an adjunct to MV repair in patients with ischemic mitral regurgitation (IMR).
  • To assess the efficacy of lifting posterior mitral annuloplasty (LPMA) in correcting IMR.

Main Methods:

  • Adult patients with IMR undergoing concomitant coronary artery bypass grafting (CABG) and lifting posterior mitral annuloplasty (LPMA) were included.
  • Immediate outcomes were assessed using transesophageal color Doppler echocardiography.
  • Success rates were compared based on baseline patient characteristics, including diabetes, hypertension, and coronary artery disease severity (two- vs. three-vessel disease).

Main Results:

  • The LPMA procedure achieved an overall immediate success rate of 93.1%.
  • Success rates were comparable between men (92.8%) and women (94.1%).
  • Significant differences in immediate success rates were observed in patients with and without diabetes and hypertension, and those with two- versus three-vessel disease.

Conclusions:

  • Lifting posterior mitral annuloplasty (LPMA) demonstrates a high percentage of successful immediate outcomes in patients with ischemic mitral regurgitation (IMR).
  • Further research is warranted to compare immediate, intermediate, and late outcomes of LPMA against other techniques.
Keywords:
acute myocardial infarctionannuloplastymitral regurgitation

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