Stress echocardiographic assessment of mitral valve function repaired using rough-zone trimming

Yohsuke Yanase, Nobuyuki Takagi, Hiroyuki Yamada, Toshitaka Watanabe, Mayuko Uehara, Kazutoshi Tachibana, Yasuko Miyaki, Toshiro Ito, Tetsuya Higami

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Article number26
JournalJournal of Cardiothoracic Surgery
Volume10
Issue number1
DOIs
StatePublished - Feb 28 2015
Externally publishedYes

Keywords

  • Echocardiography
  • Heart valve
  • Mitral regurgitation
  • Mitral valve repair
  • Surgery techniques

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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