The "ideal" management of asymptomatic severe mitral regurgitation (MR) in valve prolapse (MVP) is still debated. The aims of this study were to identify pre-operatory parameters predictive of residual MR and of early and long-term favorable remodeling after MVP repair. We included 295 patients who underwent MV repair for MVP with pre-operatory two- and three-dimensional transthoracic echocardiography (2DTTE and 3DTTE) and 6-months (6M) and 3-years (3Y) follow-up 2DTTE. MVP was classified by 3DTTE as simple or complex and surgical procedures as simple or complex. Pre-operative echo parameters were compared to post-operative values at 6M and 3Y. Patients were divided into Group 1 (6M-MR < 2) and Group 2 (6M-MR >= 2), and predictors of MR >= 2 were investigated. MVP was simple in 178/295 pts, and 94% underwent simple procedures, while in only 42/117 (36%) of complex MVP a simple procedure was performed. A significant relation among prolapse anatomy, surgical procedures and residual MR was found. Post-operative MR >= 2 was present in 9.8%: complex MVP undergoing complex procedures had twice the percentage of MR >= 2 vs. simple MVP and simple procedures. MVP complexity resulted independent predictor of 6M-MR >= 2. Favorable cardiac remodeling, initially found in all cases, was maintained only in MR < 2 at 3Y. Pre-operative 3DTTE MVP morphology identifies pts undergoing simple or complex procedures predicting MR recurrence and favorable cardiac remodeling.

Predictive Value of Pre-Operative 2D and 3D Transthoracic Echocardiography in Patients Undergoing Mitral Valve Repair: Long Term Follow Up of Mitral Valve Regurgitation Recurrence and Heart Chamber Remodeling / G. Tamborini, V. Mantegazza, M. Penso, M. Muratori, L. Fusini, S.G. Ali, C. Cefalù, G. Italiano, V. Volpato, P. Gripari, E.G. Caiani, M. Zanobini, M. Pepi. - In: JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE. - ISSN 2308-3425. - 7:4(2020 Oct 20), pp. 46.1-46.11. [10.3390/jcdd7040046]

Predictive Value of Pre-Operative 2D and 3D Transthoracic Echocardiography in Patients Undergoing Mitral Valve Repair: Long Term Follow Up of Mitral Valve Regurgitation Recurrence and Heart Chamber Remodeling

V. Mantegazza
Secondo
;
2020

Abstract

The "ideal" management of asymptomatic severe mitral regurgitation (MR) in valve prolapse (MVP) is still debated. The aims of this study were to identify pre-operatory parameters predictive of residual MR and of early and long-term favorable remodeling after MVP repair. We included 295 patients who underwent MV repair for MVP with pre-operatory two- and three-dimensional transthoracic echocardiography (2DTTE and 3DTTE) and 6-months (6M) and 3-years (3Y) follow-up 2DTTE. MVP was classified by 3DTTE as simple or complex and surgical procedures as simple or complex. Pre-operative echo parameters were compared to post-operative values at 6M and 3Y. Patients were divided into Group 1 (6M-MR < 2) and Group 2 (6M-MR >= 2), and predictors of MR >= 2 were investigated. MVP was simple in 178/295 pts, and 94% underwent simple procedures, while in only 42/117 (36%) of complex MVP a simple procedure was performed. A significant relation among prolapse anatomy, surgical procedures and residual MR was found. Post-operative MR >= 2 was present in 9.8%: complex MVP undergoing complex procedures had twice the percentage of MR >= 2 vs. simple MVP and simple procedures. MVP complexity resulted independent predictor of 6M-MR >= 2. Favorable cardiac remodeling, initially found in all cases, was maintained only in MR < 2 at 3Y. Pre-operative 3DTTE MVP morphology identifies pts undergoing simple or complex procedures predicting MR recurrence and favorable cardiac remodeling.
mitral valve disease; mitral valve prolapse; mitral valve repair; primary mitral regurgitation; three-dimensional echocardiography
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
20-ott-2020
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/950364
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