Preoperative mitral valve annulus area size is an important factor in avoiding functional mitral stenosis after mitral valve repair.

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Echocardiography Pub Date : 2024-11-21 DOI:10.1007/s12574-024-00671-x

Haruka Sasaki, Hiroyuki Takaoka, Kazuki Yoshida, Moe Matsumoto, Yusei Nishikawa, Yoshitada Noguchi, Shuhei Aoki, Katsuya Suzuki, Satomi Yashima, Makiko Kinoshita, Noriko Suzuki-Eguchi, Shuichiro Takanashi, Goro Matsumiya, Yoshio Kobayashi

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Abstract

Background: Functional mitral stenosis (FMS) following mitral valve (MV) repair for degenerative mitral regurgitation (DMR) is known as a poor prognostic factor. The parameters for avoiding postoperative FMS in MV repair for DMR have not been established.

Methods: Two-hundred-and-twenty patients (mean age 61.1 ± 13.3 years, 144 males) who underwent MV repair for DMR were analyzed. MV annulus area was measured pre- and postoperatively using three-dimensional transesophageal echocardiography (TEE). Trans-mitral pressure gradient (TMPG) was evaluated by postoperative transthoracic echocardiography and FMS was defined as a mean TMPG ≥ 5 mmHg.

Results: FMS was present in 14 patients (6.4%). Pre- versus postoperative MV annulus area change ratio was greater in the FMS group than in the non-FMS group (62.5 ± 7.2% vs. 48 ± 11.2%, p < 0.0001). On multivariate logistic regression analysis, MV annulus area change ratio was an independent predictor of FMS (odds ratio 1.19, 95% confidence interval 1.09-1.33, p < 0.0001), while receiver operating characteristics analysis showed that the optimal threshold for MV annulus area change ratio to predict FMS was 56.2% (area under the curve, 0.87; p < 0.0001).

Conclusion: The preoperative MV annulus area on TEE can be used to determine the postoperative MV annulus area to avoid FMS after MV repair.

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术前二尖瓣瓣环面积大小是二尖瓣修复术后避免功能性二尖瓣狭窄的重要因素。

背景：众所周知，退行性二尖瓣反流（DMR）二尖瓣修复术后功能性二尖瓣狭窄（FMS）是一个不良预后因素。在二尖瓣修复术治疗退行性二尖瓣反流时，避免术后功能性二尖瓣狭窄的参数尚未确定：分析了 222 名因 DMR 而接受中压修补术的患者（平均年龄 61.1 ± 13.3 岁，男性 144 人）。使用三维经食道超声心动图（TEE）测量了术前和术后的中压瓣环面积。术后经胸超声心动图评估了经中膈压力梯度（TMPG），FMS的定义是平均TMPG≥5 mmHg：结果：14 名患者（6.4%）出现 FMS。FMS 组术前与术后中压环面积变化比大于非 FMS 组（62.5 ± 7.2% vs. 48 ± 11.2%，P 结论：FMS 组患者术前中压环面积变化比大于非 FMS 组（62.5 ± 7.2% vs. 48 ± 11.2%，P 结论）：TEE 上的术前中压环面积可用于确定术后中压环面积，以避免中压修补术后出现 FMS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Echocardiography CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.00

自引率

6.20%

发文量

期刊介绍： The Journal of Echocardiography, the official journal of the Japanese Society of Echocardiography, publishes work that contributes to progress in the field and articles in clinical research as well, seeking to develop a new focus and new perspectives for all who are concerned with this discipline. The journal welcomes original investigations, review articles, letters to the editor, editorials, and case image in cardiovascular ultrasound, which will be reviewed by the editorial board. The Journal of Echocardiography provides the best of up-to-date information from around the world, presenting readers with high-impact, original work focusing on pivotal issues.