Regional Changes in Coaptation Geometry After Reduction Annuloplasty for Functional Mitral Regurgitation

被引:14
作者
Greenhouse, David G. [1 ]
Dellis, Sophia L. [1 ]
Schwartz, Charles F. [1 ]
Loulmet, Didier F. [1 ]
Yaffee, David W. [1 ]
Galloway, Aubrey C. [1 ]
Grossi, Eugene A. [1 ]
机构
[1] NYU, Sch Med, Dept Cardiothorac Surg, New York, NY USA
关键词
3-DIMENSIONAL TRANSESOPHAGEAL ECHOCARDIOGRAPHY; HEART-FAILURE; INSIGHTS; ANATOMY; RING;
D O I
10.1016/j.athoracsur.2012.02.066
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. While it is known that band annuloplasty for functional mitral regurgitation (FMR) improves leaflet coaptation, the effect on regional coaptation geometry has not previously been well defined. We used three-dimensional transesophageal echocardiography (3D-TEE) to analyze the regional effects of semirigid band annuloplasty on annular geometry and leaflet coaptation zones of patients with FMR. Methods. Sixteen patients with severe FMR underwent a semirigid band annuloplasty. Intraoperative full volume 3D-TEE datasets were acquired pre valve and post valve repair. Offline analysis assessed annular dimensions and regional coaptation zone geometry. The regions were defined as R1 (A1-P1), R2 (A2-P2), and R3 (A3-P3); coaptation distance, coaptation depth, and coaptation length were measured in each region. Differences were analyzed with repeated measures within a general linear model. Results. Band annuloplasty decreased mitral regurgitation grade from 3.7 to 0.1 (scale 0 to 4). Annular septolateral dimension (p < 0.01) and coaptation distance (p < 0.01) decreased significantly in all regions. Likewise, anterior and posterior leaflet coaptation lengths increased in all regions (p < 0.01 and p = 0.05, respectively), with region 2 showing the greatest increase (p = 0.01). Changes in coaptation depth were not significant. Conclusions. Semirigid band annuloplasty for FMR produces significant regional remodeling of leaflet coaptation zones, with region 2 showing the greatest increase in leaflet coaptation length. This regional analysis of annular geometry and leaflet coaptation creates a framework to better understand the mechanisms of surgical success or failure of annuloplasty for FMR.
引用
收藏
页码:1876 / 1880
页数:5
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