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Effect of Recurrent Mitral Regurgitation After Mitral Valve Repair in Patients With Degenerative Mitral Regurgitation

Authors
 Jung-Hwan Kim  ;  Seung Hyun Lee  ;  Hyun-Chel Joo  ;  Young-Nam Youn  ;  Kyung-Jong Yoo  ;  Byung-Chul Chang  ;  Sak Lee 
Citation
 Circulation Journal, Vol.82(1) : 93-101, 2018 
Journal Title
 Circulation Journal 
ISSN
 1346-9843 
Issue Date
2018
Keywords
Mitral regurgitation ; Mitral valve ; Valvular diseases
Abstract
BACKGROUND: This study investigated the consequences of recurrent mitral regurgitation (MR) after mitral valve (MV) repair in patients with degenerative MR and risk factors for recurrence.Methods and Results:From January 1990 to December 2015, 792 patients underwent MV repair due to degenerative MR. Recurrent MR was defined as moderate-to-severe MR on follow-up echocardiography. Mean follow-up duration was 8.71+/-5.58 years. During the follow-up period, MR recurred in 133 (16.8%) patients, and the MR recurrence-free rate at 20 years was 77.5+/-2.0%. In the recurrence group, the degree of MR decreased in 8 (6.0%) patients and was aggravated in 46 (34.6%) patients. Recurrent MR was associated with increased mortality and adverse left ventricular (LV) remodeling. Independent risk factors for MR recurrence were MV repair performed before 2000, preoperative atrial fibrillation, high LV end-diastolic dimension (LVEDD), prolapse of the isolated anterior leaflet or multiple segments, and absence of ring annuloplasty. Predictors of MR progression were high LVEDD and repair without artificial chordae implantation. CONCLUSIONS: Recurrent MR after MV repair in patients with degenerative MR showed a tendency to progress and was associated with increased mortality and adverse LV remodeling. Early referral for MV repair before development of atrial fibrillation and LV enlargement may reduce the risk of MR recurrence. Moreover, artificial chordae implantation and ring annuloplasty may assure the long-term durability of MV repair.
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DOI
10.1253/circj.CJ-17-0380
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
김정환(Kim, Jung Hwan)
유경종(Yoo, Kyung Jong) ORCID logo https://orcid.org/0000-0002-9858-140X
윤영남(Youn, Young Nam)
이삭(Lee, Sak) ORCID logo https://orcid.org/0000-0001-6130-2342
이승현(Lee, Seung Hyun) ORCID logo https://orcid.org/0000-0002-0311-6565
장병철(Chang, Byung Chul)
주현철(Joo, Hyun Chel) ORCID logo https://orcid.org/0000-0002-6842-2942
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161844
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