TY - JOUR
T1 - Stress echocardiographic assessment of mitral valve function repaired using rough-zone trimming
AU - Yanase, Yohsuke
AU - Takagi, Nobuyuki
AU - Yamada, Hiroyuki
AU - Watanabe, Toshitaka
AU - Uehara, Mayuko
AU - Tachibana, Kazutoshi
AU - Miyaki, Yasuko
AU - Ito, Toshiro
AU - Higami, Tetsuya
N1 - Publisher Copyright:
© 2015 Yanase et al.; licensee BioMed Central.
PY - 2015/2/28
Y1 - 2015/2/28
N2 - Background: We invented novel mitral valve repair technique; rough-zone trimming procedure (RZT) for anterior mitral valve prolapse. Prolapse site was resected in obtuse triangle shape and sutured edges to creates deep coaptation and improves regurgitation. Though it is simple and reproducible technique, functional mitral stenosis is a risk. Valve function and hemodynamics were investigated using dobutamine stress echocardiography (DSE) in patients after mitral valve repair using RZT. Methods: Patients underwent RZT for the anterior mitral valve (AML, n = 10), quadrangular resection (QR) of the posterior mitral valve (PML; n = 4), RZT + QR of bileaflet valves (bileaflet; n = 4) and healthy individuals (control; n = 10) and were assessed by DSE (doses up to 20 μg/Kg/min). Echocardiographic data including mitral valve area (MVA), mitral valve mean pressure gradient (MVmeanPG), and systolic pulmonary artery pressure (sPAP) were measured at rest and at peak stress. Results: Rest/stress MVA (cm2), MVmeanPG (mmHg) and sPAP (mmHg) were 2.8 ± 0.4 and 3.4 ± 0.3, 3.3 ± 1.1 and 7.4 ± 4.1, and 25.7 ± 4.7and 49.1 ± 4.1, respectively, in the AML group. Dobutamine stress increased all parameters but not to pathological levels. The results were similar to those of the other groups after mitral valve repair, whereas MVA was larger and MVmeanPG was lower in the control than in the AML group. Conclusions: Valve repair using RZT does not pathologically obstruct the mitral valve, either at baseline or during dobutamine stress, and does not affect valve hemodynamics and reserve.
AB - Background: We invented novel mitral valve repair technique; rough-zone trimming procedure (RZT) for anterior mitral valve prolapse. Prolapse site was resected in obtuse triangle shape and sutured edges to creates deep coaptation and improves regurgitation. Though it is simple and reproducible technique, functional mitral stenosis is a risk. Valve function and hemodynamics were investigated using dobutamine stress echocardiography (DSE) in patients after mitral valve repair using RZT. Methods: Patients underwent RZT for the anterior mitral valve (AML, n = 10), quadrangular resection (QR) of the posterior mitral valve (PML; n = 4), RZT + QR of bileaflet valves (bileaflet; n = 4) and healthy individuals (control; n = 10) and were assessed by DSE (doses up to 20 μg/Kg/min). Echocardiographic data including mitral valve area (MVA), mitral valve mean pressure gradient (MVmeanPG), and systolic pulmonary artery pressure (sPAP) were measured at rest and at peak stress. Results: Rest/stress MVA (cm2), MVmeanPG (mmHg) and sPAP (mmHg) were 2.8 ± 0.4 and 3.4 ± 0.3, 3.3 ± 1.1 and 7.4 ± 4.1, and 25.7 ± 4.7and 49.1 ± 4.1, respectively, in the AML group. Dobutamine stress increased all parameters but not to pathological levels. The results were similar to those of the other groups after mitral valve repair, whereas MVA was larger and MVmeanPG was lower in the control than in the AML group. Conclusions: Valve repair using RZT does not pathologically obstruct the mitral valve, either at baseline or during dobutamine stress, and does not affect valve hemodynamics and reserve.
KW - Echocardiography
KW - Heart valve
KW - Mitral regurgitation
KW - Mitral valve repair
KW - Surgery techniques
UR - http://www.scopus.com/inward/record.url?scp=85028235524&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85028235524&partnerID=8YFLogxK
U2 - 10.1186/s13019-015-0232-y
DO - 10.1186/s13019-015-0232-y
M3 - Article
C2 - 25880165
AN - SCOPUS:85028235524
SN - 1749-8090
VL - 10
JO - Journal of Cardiothoracic Surgery
JF - Journal of Cardiothoracic Surgery
IS - 1
M1 - 26
ER -