Reverse remodeling of left heart following mitral valve repair in case of mesenchimal dysplasia
Objectives. Volume overload in mitral regurgitation leads to compensatory dilation of the left heart chambers. Surgical correction promotes reverse remodeling of the heart. In this study, focus was placed on the changes in the left heart resulted from mitral regurgitation correction by using two dif...
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| Format: | Article |
| Language: | English |
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Meshalkin National Medical Research Center
2015-10-01
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| Series: | Патология кровообращения и кардиохирургия |
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| Online Access: | http://journalmeshalkin.ru/index.php/heartjournal/article/view/8 |
| _version_ | 1827886893926187008 |
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| author | А. М. Караськов Р. М. Тулеутаев А. В. Богачёв-прокофьев С. И. Железнёв А. В. Афанасьев |
| author_facet | А. М. Караськов Р. М. Тулеутаев А. В. Богачёв-прокофьев С. И. Железнёв А. В. Афанасьев |
| author_sort | А. М. Караськов |
| collection | DOAJ |
| description | Objectives. Volume overload in mitral regurgitation leads to compensatory dilation of the left heart chambers. Surgical correction promotes reverse remodeling of the heart. In this study, focus was placed on the changes in the left heart resulted from mitral regurgitation correction by using two different surgical techniques for mitral valve repair. Methods. 94 patients with posterior mitral valve prolapse were randomized in two groups. The first group patients underwent artificial chordal replacement, while a leaflet resection technique was used for the patients of the second group. Preoperative transthoracic and intraoperative transesophageal echocardiography was performed for all patients and data were obtained at 10-12 days after surgery and during long-term follow up. Results. In the early postoperative period, significant reverse remodeling of the left heart chambers was observed (LA 5.4-4.6, p <0.05; LVEDD 5.8-4.9 p <0.05; LVESD 3.6 - 3.1 p <0.05) - LA 5.2 - 4.5 p <0.05; LVEDD 5.8 - 4.8 p <0.05; LVESD 3.5 - 3.2 p <0.05. The mitral valve orifice area in the groups was 3.3 - 3.3 - 3.2 when replacing chords and 3.5 - 3.4 - 3.2 when doing resection, with p being equal to 0.32, 0.36 and 0.51 respectively. The mean diastolic gradient in the first group was 2.0 - 3.0 - 3.0 mm Hg, while in the second one it amounted to 2.3 - 3.2 - 3.3 mmHg, with p <0.05. Conclusion. The authors conclude that significant remodeling of the left heart occurs in the early postoperative period. In the immediate postoperative period, the mitral valve area tends to decrease and the gradient has a tendency to increase in both groups, with no significant changes observed in the late postoperative period. |
| first_indexed | 2024-03-12T20:09:28Z |
| format | Article |
| id | doaj.art-2f8f1c3e923a474687bb76aba830cdd9 |
| institution | Directory Open Access Journal |
| issn | 1681-3472 2500-3119 |
| language | English |
| last_indexed | 2024-03-12T20:09:28Z |
| publishDate | 2015-10-01 |
| publisher | Meshalkin National Medical Research Center |
| record_format | Article |
| series | Патология кровообращения и кардиохирургия |
| spelling | doaj.art-2f8f1c3e923a474687bb76aba830cdd92023-08-02T01:47:51ZengMeshalkin National Medical Research CenterПатология кровообращения и кардиохирургия1681-34722500-31192015-10-01191667110.21688/1681-3472-2015-1-66-71728Reverse remodeling of left heart following mitral valve repair in case of mesenchimal dysplasiaА. М. Караськов0Р. М. Тулеутаев1А. В. Богачёв-прокофьев2С. И. Железнёв3А. В. Афанасьев4ФГБУ «ННИИПК им. акад. Е.Н. Мешалкина» Минздрава РоссииФГБУ «ННИИПК им. акад. Е.Н. Мешалкина» Минздрава РоссииФГБУ «ННИИПК им. акад. Е.Н. Мешалкина» Минздрава РоссииФГБУ «ННИИПК им. акад. Е.Н. Мешалкина» Минздрава РоссииФГБУ «ННИИПК им. акад. Е.Н. Мешалкина» Минздрава РоссииObjectives. Volume overload in mitral regurgitation leads to compensatory dilation of the left heart chambers. Surgical correction promotes reverse remodeling of the heart. In this study, focus was placed on the changes in the left heart resulted from mitral regurgitation correction by using two different surgical techniques for mitral valve repair. Methods. 94 patients with posterior mitral valve prolapse were randomized in two groups. The first group patients underwent artificial chordal replacement, while a leaflet resection technique was used for the patients of the second group. Preoperative transthoracic and intraoperative transesophageal echocardiography was performed for all patients and data were obtained at 10-12 days after surgery and during long-term follow up. Results. In the early postoperative period, significant reverse remodeling of the left heart chambers was observed (LA 5.4-4.6, p <0.05; LVEDD 5.8-4.9 p <0.05; LVESD 3.6 - 3.1 p <0.05) - LA 5.2 - 4.5 p <0.05; LVEDD 5.8 - 4.8 p <0.05; LVESD 3.5 - 3.2 p <0.05. The mitral valve orifice area in the groups was 3.3 - 3.3 - 3.2 when replacing chords and 3.5 - 3.4 - 3.2 when doing resection, with p being equal to 0.32, 0.36 and 0.51 respectively. The mean diastolic gradient in the first group was 2.0 - 3.0 - 3.0 mm Hg, while in the second one it amounted to 2.3 - 3.2 - 3.3 mmHg, with p <0.05. Conclusion. The authors conclude that significant remodeling of the left heart occurs in the early postoperative period. In the immediate postoperative period, the mitral valve area tends to decrease and the gradient has a tendency to increase in both groups, with no significant changes observed in the late postoperative period.http://journalmeshalkin.ru/index.php/heartjournal/article/view/8МЕЗЕНХИМАЛЬНАЯ ДИСПЛАЗИЯMITRAL VALVE REPAIRПРОТЕЗИРОВАНИЕ ХОРДRESECTIONCHORDAL REPLACEMENT |
| spellingShingle | А. М. Караськов Р. М. Тулеутаев А. В. Богачёв-прокофьев С. И. Железнёв А. В. Афанасьев Reverse remodeling of left heart following mitral valve repair in case of mesenchimal dysplasia Патология кровообращения и кардиохирургия МЕЗЕНХИМАЛЬНАЯ ДИСПЛАЗИЯ MITRAL VALVE REPAIR ПРОТЕЗИРОВАНИЕ ХОРД RESECTION CHORDAL REPLACEMENT |
| title | Reverse remodeling of left heart following mitral valve repair in case of mesenchimal dysplasia |
| title_full | Reverse remodeling of left heart following mitral valve repair in case of mesenchimal dysplasia |
| title_fullStr | Reverse remodeling of left heart following mitral valve repair in case of mesenchimal dysplasia |
| title_full_unstemmed | Reverse remodeling of left heart following mitral valve repair in case of mesenchimal dysplasia |
| title_short | Reverse remodeling of left heart following mitral valve repair in case of mesenchimal dysplasia |
| title_sort | reverse remodeling of left heart following mitral valve repair in case of mesenchimal dysplasia |
| topic | МЕЗЕНХИМАЛЬНАЯ ДИСПЛАЗИЯ MITRAL VALVE REPAIR ПРОТЕЗИРОВАНИЕ ХОРД RESECTION CHORDAL REPLACEMENT |
| url | http://journalmeshalkin.ru/index.php/heartjournal/article/view/8 |
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