Skip to main content
SpringerLink
Log in

Mitral valve repair for ischemic mitral incompetence

  • Chapter
Mitral Valve Repair

  • 1031 Accesses

Abstract

Ischemic mitral incompetence (IMI) is the most frequent mechanism of mitral regurgitation today and will continue to be so in the future, particularly in developed countries where rheumatic mitral valve disease has been nearly eradicated. It is a complex multifactorial entity related to coronary artery disease that is a frequent complication of myocardial infarction and associated with a poor prognosis. It involves global and regional left ventricular remodeling as well as dysfunction and distortion of the mitral valve (MV), including the chordae, annulus, and leaflets. Mitral regurgitation in the IMI mechanism is characterized by restrictive mitral leaflet mobility due to dyskinesia or even akinesia of the ventricular wall which bears one or both papillary muscles, thus, extending the distance between the ventricular wall and the leaflets, either both or, most frequently, predominantly the posterior leaflet. The posterior papillary muscle and its supporting ventricular wall and the posterior–inferior wall of the left ventricle are most frequently affected.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Hetzer R, Delmo Walter EM (2010) Repair of congenital mitral valve insufficiency. Oper TechThorac Cardiovasc Surg A Comparative Atlas.15(4)260–272

    Google Scholar 

  2. Bolling SF (2001) Mitral valve reconstruction in the patient with heart failure. Heart Failure Reviews 6:177–185

    Article  PubMed  CAS  Google Scholar 

  3. Gerbode FL, Hetzer R, Krebber HJ (1978) Surgical management of papillary muscle rupture to myocardial infarction. World J Surg 2:791–796

    Article  PubMed  CAS  Google Scholar 

  4. Duarte IG, Murphy CO, Kosinski AS, Jnes EL, Craver JM, Gott JP, Guyton RA (1997) Late survival after valve operation in patients with left ventricular dysfunction. Ann Thorac Surg 64:1089–1095

    Article  PubMed  CAS  Google Scholar 

  5. Wu AH, Aaronson KD, Bolling SF, Pagani FD, Welch K, Koelling TM (2005) Impact of mitral valve annuloplasty on mortality risk in patients with mitral regurgitation and left ventricular systolic dysfunction. J Am Coll Cardiol 45:388–390

    Article  Google Scholar 

  6. Bishay ES, McCarthy PM, Cosgrove DM, et al. (2000) Mitral valve surgery in patients with severe left ventricular dysfunction. Eur J Cardiothorac Surg 17:213–221

    Article  PubMed  CAS  Google Scholar 

  7. Rostagno C, Caciolli S, Fradella GF, Stefano PL (2007) Early effects of mitral valve repair in patients with left ventricular dysfunction: an echocardiographic study. Eur J Heart Fail(suppl):26

    Google Scholar 

  8. Duarte IG, Shen Y, MacDonald MJ, Jones EL, Craver JM, Guyton RA (1999) Treatment of moderate regurgitation and coronary disease by coronary bypass alone: late results. Ann Thorac Surg 68:426–430

    Article  PubMed  CAS  Google Scholar 

  9. Jones EL, Weintraub WS, Craver JM, Guyton RA, Shen Y (1994) Interaction of age and coronary disease after valve replacement: implications for valve selection. Ann Thorac Surgery 58:378–385

    Article  CAS  Google Scholar 

  10. Ashraff SS, Shaukat N, Odom N, Keenan D, Grotte G (1994) Early and late results following combined coronary bypass surgery and mitral valve replacement. Eur J Cardiothorac Surg 8:57–162

    Article  Google Scholar 

  11. Hendren WC, Nemec JJ, Lytle BW, Loop FD, Taylor PC, Stewart RW, Cosgrove DM (1991) Mitral valve repair for ischemic mitral insufficiency. Ann Thorac Surg 52:1246–1252

    Article  PubMed  CAS  Google Scholar 

  12. Kay GL, Kay JH, Zubiate P, Yokoyama T, Mendez M (1986) Mitral valve repair for mitral regurgitation secondary to artery disease. Circulation 74(suppl I):88–98

    Google Scholar 

  13. Rankin JS, Livesey SA, smith LR, et al. (1989) Trends in the surgical treatment of ischemic mitral regurgitation: effects of mitral valve repair on hospital mortality. Semin Thorac Cardiovasc Surg 1:149–163

    PubMed  CAS  Google Scholar 

  14. Von Oppell UO, Stemmet F, Brink J, Commerford PJ, Heijke SA (2000) Ischemic mitral valve surgery. J Heart Valve Dis 9:64–73

    Google Scholar 

  15. Lee EM, Shapiro LM, Well FC (1995) Mortality and morbidity after mitral valve repair. The importance of left ventricular function. J Heart Valve Dis 4:460–468

    PubMed  CAS  Google Scholar 

  16. Rankin JS, Hickey MSJ, Smith LR, DeBruijn NP, Sheikh KH, Sabiston DC (1991) Current concepts in the pathogenesis and treatment of ischemic mitral regurgitation. In: Vetter, Hetzer, Schmutzler (eds) Ischemic Mitral Incompetence. Springer Verlag, Heidelberg, pp 127–178

    Google Scholar 

  17. Menicanti L, Di Donato M, Frigiola A, Buckberg G, Santambrogio C, Ranucci M, Santo D, RESTORE roup (2002) Ischemic mitral regurgitation: intraventricular papillary muscle imbrication without mitral ring during left ventricular restoration. J Cardiothorac Surg123:1041–1050

    CAS  Google Scholar 

  18. Rothenburger M, Rokusujew A, Hammel D, Dorenkamp A, Scheld HH (2002) Mitral valve surgery in patients with poor left ventricular dysfunction. Thorac Cardiovasc Surg 6:351–354

    Article  Google Scholar 

  19. Szalay ZA. Civelek A, Hobe S, Brunner-LaRocca HP, Klovekorn WP, Knez I, Vogt PR, Bauer EP (2003) Mitral annuloplasty in patients with ischemic versus dilated cardiomyopathy. Eur J Cardiothorac Surg 4:567–572

    Article  Google Scholar 

  20. Chen F, Adams D, Aranki S, Collins J, Couper G, Rizzo R, Cohn L (1998) Mitral valve repair in cardiomyopathy. Circulation 98:II124–II127

    PubMed  CAS  Google Scholar 

  21. Lachmann J, Shirani J, Pletis K, Frater R, Le Jemtel T (2001) Mitral ring annuloplasty: an incomplete correction of functional mitral regurgitation associated with left ventricular remodeling. Curr Cardiol Rep 3:241–246

    Article  PubMed  CAS  Google Scholar 

  22. Bolling S (2002) Mitral reconstruction in cardiomyopathy. J Heart Valve Dis 11:S25–S31

    Google Scholar 

  23. Silberman S, Klutstein MW, Sabag T, Oren A, Fink D, Merin O, Bitran D (2009) Repair of ischemic mitral regurgitation: comparison between flexible and rigid annuloplasty rings. Ann Thorac Surg 87:1721–1727

    Article  PubMed  Google Scholar 

  24. Hetzer R, Drews T, S iniawski H, Komoda T, Hofmeister J, Weng Y (1995). preservation of papillary muscles and chordae during mitral valve replacement: possibilities and limitations. J Heart Valve Disease 4(Suppl II):S115–S123

    Google Scholar 

  25. David TE, Uden DE, Strauss HD (1983) The importance of the mitral apparatus in left ventricular function after correction of mitral regurgitation. Circulation 68(3 pt 2):1176–1182

    Google Scholar 

  26. Sarris GE, Cahill PD, Hansen DE, Derby GC, Miller DC (1988) Restoration of left ventricular systolic performance after reattachment of the mitral chordae tendineae. The importance of valvular-ventricular interaction. J Thorac Cardiovasc Surg 95:969–979

    PubMed  CAS  Google Scholar 

  27. Huikuri HV (1983) Effect of mitral valve replacement on left ventricular function in mitral regurgitation. Br Heart J 49:328–333

    Article  PubMed  CAS  Google Scholar 

  28. Tischler MD, Cooper KA, Rowen M, Le Winter MM (1994) Myocardial function/valvular heart disease/hypertensive heart disease: mitral valve replacement versus mitral valve repair: a Doppler and quantitative stress echocardiographic study. Circulation 89:132–137

    PubMed  CAS  Google Scholar 

  29. Hausmann H, Siniawski H, Hotz H, Hofmeister J, Chavez T, Schmidt G, Hetzer R (1997) Mitral valve reconstruction and mitral valve replacement in ischemic mitral insufficiency. J Card Surg 12:8–14

    Article  PubMed  CAS  Google Scholar 

  30. Hausmann H, Siniawski H, Hetzer R (1999) Mitral valve reconstruction and replacement for ischemic mitral insufficiency: seven years’ follow-up. J Heart Valve Dis 8:536–542

    PubMed  CAS  Google Scholar 

  31. Prifti E, Bonacchi M, Frati G, et al. (2000) Early and midterm outcome of coronary artery bypass grafting in endstage coronary artery disease patients. Cor Europaeum 8:93–99

    Google Scholar 

  32. Czer LS, Maurer G, Bolger AF, De Robertis M, Chaux A, Matloff JM (1996) Revascularization alone or in combined with suture annuloplasty for ischemic mitral regurgitation: evaluation by color Doppler echocardiography. Tex heart Inst J 23:270–278

    PubMed  CAS  Google Scholar 

  33. Christenson JT, Simonet F, Bloch A, Maurice J, Schmuziger M (1995) Should a mild to moderate mitral valve regurgitation in patients with poor left ventricular function be repaired or not. J Heart Valve Dis 4:484–488

    PubMed  CAS  Google Scholar 

  34. Pinson CW Cobanoglu A, Metzdorff MT, Grunkemeier GL, Kay PH, Starr A (1984) Late surgical results for ischemic mitral regurgitation. Role of wall motion score and severity of regurgitation. J Thorac Cardiovasc Surg 88:663–672

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Deutsches Herzzentrum Berlin, Charité Medical University Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    R. Hetzer MD, PhD (Chairman Professor of Surgery)

  2. Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    E.M. Delmo Walter MD, MSc, PhD

Authors
  1. R. Hetzer MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E.M. Delmo Walter MD, MSc, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Deutsches Herzzentrum Berlin, Charité Medical University Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Roland Hetzer MD, PhD (Chairman Professor of Surgery) (Chairman Professor of Surgery)

  2. Department of Cardiac Surgery, Vanderbilt University Medical Center, 320 Lynnwood Blvd., 37205, Nashville, TN, USA

    J. Scott Rankin MD (Associate Clinical Professor of Surgery) (Associate Clinical Professor of Surgery)

  3. Consultant Cardiothoracic & Vascular Surgeon Deutsches Herzzentrum Berlin, Charité Medical University Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Charles A. Yankah MD, PhD (Professor of Surgery) (Professor of Surgery)

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Hetzer, R., Delmo Walter, E. (2011). Mitral valve repair for ischemic mitral incompetence. In: Hetzer, R., Rankin, J., Yankah, C. (eds) Mitral Valve Repair. Steinkopff. https://doi.org/10.1007/978-3-7985-1867-4_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-7985-1867-4_15

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-7985-1866-7

  • Online ISBN: 978-3-7985-1867-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation