Original articleAdult cardiacClinical and Functional Effects of Restrictive Mitral Annuloplasty at Midterm Follow-Up in Heart Failure Patients
Section snippets
Patients
The study group consisted of 11 patients with cardiomyopathy, New York Heart Association (NYHA) class III/IV, LV ejection fraction (LVEF) less than 0.35, and MR grade 2 or greater, who were scheduled for RMA. The mechanism of MR was based on malcoaptation due to LV dilatation. Patients received optimal medical management for heart failure. Patients with primary mitral valve dysfunction (prolapse, rheumatic disease, stenosis) or a biologic or mechanical prosthesis in the aortic position were
Surgical and Clinical Data
We enrolled 11 patients (6 male, 5 female; 65 ± 16 years), All patients underwent RMA (median ring size, 26; range, 24 to 28). Eight patients were diagnosed with ischemic cardiomyopathy of which 6 underwent additional CABG, one was already revascularized (CABG) in the past, and one had proven irreversible ischemia. In 6 patients with severe tricuspid regurgitation, a concomitant restrictive tricuspid annuloplasty was performed (median ring size, 26; range, 26 to 30). Cardiopulmonary bypass
Comment
Recent studies demonstrated good survival rates after RMA surgery of approximately 90% and 70% at 1-year and 5-year follow-up, respectively. Although no significant difference in survival rate could be detected when comparing CABG with additional RMA versus CABG alone [13, 28, 29], the efficacy of adding RMA to CABG was demonstrated by improved clinical performance according to improved NYHA class [12]. Furthermore, improved exercise tolerance was demonstrated by treadmill stress tests in
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