Progress in Surgical Treatment of Ischemic Mitral Regurgitation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIQi-fan ¹ , CHENGWang-wang ¹ ,  ZHANGYang-yang ²

1. The First Clinical College of Nanjing Medical University, Nanjing 211100, P. R. China;
2. Department of Cardiothoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China;

Corresponding author：

ZHANGYang-yang, Email: zhangyangyang_md@sina.com

Keywords：

Ischemic mitral regurgitation; Myocardial infarction; Surgical treatment

DOI：

10.7507/1007-4848.20160219

Video：

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Ischemic mitral regurgitation is the common complication after myocardial infarction. Ischemic mitral regurgitation which can be described as the modification of the ventricle caused by myocardial infarction remarkably increases the risk of developing congestive heart failure and mortality after myocardial infarction. The imbalanced dynamic of tethering and occluding of the leaflets or the annular dilatation can result in ischemic mitral regurgitation. We have to diagnose, evaluate ischemic mitral regurgitation timely and perform surgical treatment effectively. It has significant meaning to improve the prognosis of patients.

Citation： LIQi-fan, CHENGWang-wang, ZHANGYang-yang. Progress in Surgical Treatment of Ischemic Mitral Regurgitation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(9): 916-920. doi: 10.7507/1007-4848.20160219 Copy

1.	Bursi F, Enriquez-Sarano M, Jacobsen SJ, et al. Mitral regurgitation after myocardial infarction:a review. Am J Med, 2006, 119(2):103-112.
2.	Petris AO, Iliescu D, Alexandrescu DM, et al. Ischemic mitral regurgitation in patients with acute myocardial infarction. Rev Med Chir Soc Med Nat Iasi, 2014, 118(3):618-623.
3.	Amigoni M, Meris A, Thune JJ, et al. Mitral regurgitation in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both:prognostic significance and relation to ventricular size and function. Eur Heart J, 2007, 28(3):326-333.
4.	Heikkilä J. Mitral incompetence as a complication of acute myocardial infarction. Acta med Scand Suppl, 1967, 475:1-149.
5.	Tibayan FA, Rodriguez F, Zasio MK, et al. Geometric distortions of the mitral valvular-ventricular complex in chronic ischemic mitral regurgitation. Circulation, 2003, 108(10 suppl 1):Ⅱ116-Ⅱ121.
6.	Yiu SF, Enriquez-Sarano M, Tribouilloy C, et al. Determinants of the degree of functional mitral regurgitation in patients with systolic left ventricular dysfunction:a quantitative clinical study. Circulation, 2000, 102(12):1400-1406.
7.	Timek TA, Lai DT, Tibayan F, et al. Ischemia in three left ventricular regions:Insights into the pathogenesis of acute ischemic mitral regurgitation. J Thorac Cardiovasc Surg, 2003, 125(3):559-569.
8.	Oppizzi M, Maisano F, De Bonis M, et al. Echocardiographic classification of chronic ischemic mitral regurgitation caused by restricted motion according to tethering pattern. Eur J Echocardiography, 2004, 5(5):326-334.
9.	Ramadan R, Al-Attar N, Mohammadi S, et al. Left ventricular infarct plication restores mitral function in chronic ischemic mitral regurgitation. J Thorac Cardiovasc Surg, 2005, 129(2):440-442.
10.	Ahmad RM, Gillinov AM, McCarthy PM, et al. Annular geometry and motion in human ischemic mitral regurgitation:novel assessment with three-dimensional echocardiography and computer reconstruction. Ann Thorac Surg, 2004, 78(6):2063-2068.
11.	Nickoloff BJ, Lewinsohn DM, Butcher EC, et al. Recombinant Gamma interferon increases the binding of peripheral blood mononuclear leukocytes and a leu-3 & plus; T lymphocyte clone to cultured keratinocytes and to a malignant cutaneous squamous carcinoma cell line that is blocked by antibody against the LFA-1 Molecule. J Invest Dermat, 1988, 90(1):17-22.
12.	Schwammenthal E, Chen C, Benning F, et al. Dynamics of mitral regurgitant flow and orifice area. Physiologic application of the proximal flow convergence method:clinical data and experimental testing. Circulation, 1994, 90(1):307-322.
13.	Gianfaldoni ML, Venturi F, Petix NR, et al. Quantitative evaluation of functional mitral insufficiency in dilated cardiomyopathy:morphological and functional correlations. Ital Heart J Suppl, 2002, 3(7):738-745.
14.	Matsui Y, Suto Y, Shimura S, et al. Impact of papillary muscles approximation on the adequacy of mitral coaptation in functional mitral regurgitation due to dilated cardiomyopathy. Ann Thorac Cardiovasc Surg, 2005, 11(3):164.
15.	Ryan L, Jackson B, Parish L, et al. Quantification and localization of mitral valve tenting in ischemic mitral regurgitation using real-time three-dimensional echocardiography. Eur J Cardio-thorac Surg, 2007, 31(5):839-844.
16.	Abe Y, Imai T, Ohue K, et al. Relation between reduction in ischaemic mitral regurgitation and improvement in regional left ventricular contractility during low dose dobutamine stress echocardiography. Heart, 2005, 91(8):1092-1093.
17.	Roshanali F, Mandegar MH, Yousefnia MA, et al. Low dose dobutamine stress echocardiography to predict reversibility of mitral regurgitation with CABG. Echocardiography, 2006, 23(1):31-37.
18.	Kaji S, Nasu M, Yamamuro A, et al. Annular geometry in patients with chronic ischemic mitral regurgitation three-dimensional magnetic resonance imaging study. Circulation, 2005, 112(9 suppl):I409-I414.
19.	Lam BK, Gillinov AM, Blackstone EH, et al. Importance of moderate ischemic mitral regurgitation. Ann Thorac Surg, 2005, 79(2):462-470.
20.	麦明杰, 陈星权, 郑少忆, 等.冠心病合并重度缺血性二尖瓣关闭不全的外科治疗早期疗效分析.南方医科大学学报, 2011, 31(6):1072-1074.
21.	Castleberry AW, Williams JB, Daneshmand MA, et al. Surgical revascularization is associated with maximal survival in patients with ischemic mitral regurgitation:a 20-year experience. Circulation, 2014, 129(24):2547-2556.
22.	Duarte IG, Shen Y, MacDonald MJ, et al. Treatment of moderate mitral regurgitation and coronary disease by coronary bypass alone:late results. Ann Thorac Surg, 1999, 68(2):426-430.
23.	Hamner CE, Sundt Ⅲ TM. Trends in the surgical management of ischemic mitral regurgitation. Curr Cardiol Rep, 2003, 5(2):116-124.
24.	Prifti E, Bonacchi M, Frati G, et al. Ischemic mitral valve regurgitation grade Ⅱ-Ⅲ:correction in patients with impaired left ventricular function undergoing simultaneous coronary revascularization. J Heart Valve Dis, 2001, 10(6):754-762.
25.	Christenson JT, Simonet F, Bloch A, et al. Should a mild to moderate ischemic mitral valve regurgitation in patients with poor left ventricular function be repaired or not? J Heart Valve Dis, 1995, 4(5):484-489.
26.	Rydén T, Bech-Hanssen O, Brandrup-Wognsen G, et al. The importance of grade 2 ischemic mitral regurgitation in coronary artery bypass grafting. Eur J Cardio-thorac Surg, 2001, 20(2):276-281.
27.	Aklog L, Filsoufi F, Flores KQ, et al. Does coronary artery bypass grafting alone correct moderate ischemic mitral regurgitation? Circulation, 2001, 104(suppl 1):I68-I75.
28.	Kim YH, Czer LSC, Soukiasian HJ, et al. Ischemic mitral regurgitation:revascularization alone versus revascularization and mitral valve repair. Ann Thorac Surgery, 2005, 79(6):1895-1901.
29.	Chan KMJ, Punjabi PP, Flather M, et al. Coronary artery bypass surgery with or without mitral valve annuloplasty in moderate functional ischemic mitral regurgitation final results of the randomized ischemic mitral evaluation (RIME) trial. Circulation, 2012, 126(21):2502-2510.
30.	Sá MP, Soares EF, Santos CA, et al. Mitral valve replacement combined with coronary artery bypass graft surgery in patients with moderate-to-severe ischemic mitral regurgitation. Revista Portuguesa de Cardiologia, 2013, 32(2):131-137.
31.	Antonio L, Antonio M, Egidio V, et al. Mitral valve repair versus replacement in patients with ischaemic mitral regurgitation and depressed ejection fraction:risk factors for early and mid-term mortality(aEuro). Interact Cardiovasc Thorac Surg, 2014, 19(1):64-69.
32.	Dayan V, Soca G, Cura L, et al. Similar survival after mitral valve replacement or repair for ischemic mitral regurgitation:a meta-analysis. Ann Thorac Surg, 2014, 97(3):758-765.
33.	邱志兵, 陈鑫, 徐明, 等. Ⅲb型缺血性二尖瓣反流外科治疗方式的早期临床效果及中远期疗效比较.中国胸心血管外科临床杂志, 2015, 22(9):831-836.
34.	Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease (version 2012). Revista Española de Cardiología, 2013, 66(2):131-131.
35.	Bonow RO, Carabello BA, Chatterjee K, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol, 2006, 48(3):e1-e148.
36.	Khan SS, Trento A, DeRobertis M, et al. Twenty-year comparison of tissue and mechanical valve replacement. J thorac cardiovasc surg, 2001, 122(2):257-269.
37.	Deja M A, Grayburn PA, Sun B, et al. Influence of mitral regurgitation repair on survival in the surgical treatment for ischemic heart failure trial. Circulation, 2012, 125(21):2639-2648.
38.	Kwon MH, Cevasco M, Chen FY. Functional, ischemic MR:to repair or not to repair? Circulation, 2012:CIRCULATIONAHA. 112.107805.
39.	McGee EC, Gillinov AM, Blackstone EH, et al. Recurrent mitral regurgitation after annuloplasty for functional ischemic mitral regurgitation. J Thorac Cardiovasc Surg, 2004, 128(6):916-924.

1. Bursi F, Enriquez-Sarano M, Jacobsen SJ, et al. Mitral regurgitation after myocardial infarction:a review. Am J Med, 2006, 119(2):103-112.
2. Petris AO, Iliescu D, Alexandrescu DM, et al. Ischemic mitral regurgitation in patients with acute myocardial infarction. Rev Med Chir Soc Med Nat Iasi, 2014, 118(3):618-623.
3. Amigoni M, Meris A, Thune JJ, et al. Mitral regurgitation in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both:prognostic significance and relation to ventricular size and function. Eur Heart J, 2007, 28(3):326-333.
4. Heikkilä J. Mitral incompetence as a complication of acute myocardial infarction. Acta med Scand Suppl, 1967, 475:1-149.
5. Tibayan FA, Rodriguez F, Zasio MK, et al. Geometric distortions of the mitral valvular-ventricular complex in chronic ischemic mitral regurgitation. Circulation, 2003, 108(10 suppl 1):Ⅱ116-Ⅱ121.
6. Yiu SF, Enriquez-Sarano M, Tribouilloy C, et al. Determinants of the degree of functional mitral regurgitation in patients with systolic left ventricular dysfunction:a quantitative clinical study. Circulation, 2000, 102(12):1400-1406.
7. Timek TA, Lai DT, Tibayan F, et al. Ischemia in three left ventricular regions:Insights into the pathogenesis of acute ischemic mitral regurgitation. J Thorac Cardiovasc Surg, 2003, 125(3):559-569.
8. Oppizzi M, Maisano F, De Bonis M, et al. Echocardiographic classification of chronic ischemic mitral regurgitation caused by restricted motion according to tethering pattern. Eur J Echocardiography, 2004, 5(5):326-334.
9. Ramadan R, Al-Attar N, Mohammadi S, et al. Left ventricular infarct plication restores mitral function in chronic ischemic mitral regurgitation. J Thorac Cardiovasc Surg, 2005, 129(2):440-442.
10. Ahmad RM, Gillinov AM, McCarthy PM, et al. Annular geometry and motion in human ischemic mitral regurgitation:novel assessment with three-dimensional echocardiography and computer reconstruction. Ann Thorac Surg, 2004, 78(6):2063-2068.
11. Nickoloff BJ, Lewinsohn DM, Butcher EC, et al. Recombinant Gamma interferon increases the binding of peripheral blood mononuclear leukocytes and a leu-3 & plus; T lymphocyte clone to cultured keratinocytes and to a malignant cutaneous squamous carcinoma cell line that is blocked by antibody against the LFA-1 Molecule. J Invest Dermat, 1988, 90(1):17-22.
12. Schwammenthal E, Chen C, Benning F, et al. Dynamics of mitral regurgitant flow and orifice area. Physiologic application of the proximal flow convergence method:clinical data and experimental testing. Circulation, 1994, 90(1):307-322.
13. Gianfaldoni ML, Venturi F, Petix NR, et al. Quantitative evaluation of functional mitral insufficiency in dilated cardiomyopathy:morphological and functional correlations. Ital Heart J Suppl, 2002, 3(7):738-745.
14. Matsui Y, Suto Y, Shimura S, et al. Impact of papillary muscles approximation on the adequacy of mitral coaptation in functional mitral regurgitation due to dilated cardiomyopathy. Ann Thorac Cardiovasc Surg, 2005, 11(3):164.
15. Ryan L, Jackson B, Parish L, et al. Quantification and localization of mitral valve tenting in ischemic mitral regurgitation using real-time three-dimensional echocardiography. Eur J Cardio-thorac Surg, 2007, 31(5):839-844.
16. Abe Y, Imai T, Ohue K, et al. Relation between reduction in ischaemic mitral regurgitation and improvement in regional left ventricular contractility during low dose dobutamine stress echocardiography. Heart, 2005, 91(8):1092-1093.
17. Roshanali F, Mandegar MH, Yousefnia MA, et al. Low dose dobutamine stress echocardiography to predict reversibility of mitral regurgitation with CABG. Echocardiography, 2006, 23(1):31-37.
18. Kaji S, Nasu M, Yamamuro A, et al. Annular geometry in patients with chronic ischemic mitral regurgitation three-dimensional magnetic resonance imaging study. Circulation, 2005, 112(9 suppl):I409-I414.
19. Lam BK, Gillinov AM, Blackstone EH, et al. Importance of moderate ischemic mitral regurgitation. Ann Thorac Surg, 2005, 79(2):462-470.
20. 麦明杰, 陈星权, 郑少忆, 等.冠心病合并重度缺血性二尖瓣关闭不全的外科治疗早期疗效分析.南方医科大学学报, 2011, 31(6):1072-1074.
21. Castleberry AW, Williams JB, Daneshmand MA, et al. Surgical revascularization is associated with maximal survival in patients with ischemic mitral regurgitation:a 20-year experience. Circulation, 2014, 129(24):2547-2556.
22. Duarte IG, Shen Y, MacDonald MJ, et al. Treatment of moderate mitral regurgitation and coronary disease by coronary bypass alone:late results. Ann Thorac Surg, 1999, 68(2):426-430.
23. Hamner CE, Sundt Ⅲ TM. Trends in the surgical management of ischemic mitral regurgitation. Curr Cardiol Rep, 2003, 5(2):116-124.
24. Prifti E, Bonacchi M, Frati G, et al. Ischemic mitral valve regurgitation grade Ⅱ-Ⅲ:correction in patients with impaired left ventricular function undergoing simultaneous coronary revascularization. J Heart Valve Dis, 2001, 10(6):754-762.
25. Christenson JT, Simonet F, Bloch A, et al. Should a mild to moderate ischemic mitral valve regurgitation in patients with poor left ventricular function be repaired or not? J Heart Valve Dis, 1995, 4(5):484-489.
26. Rydén T, Bech-Hanssen O, Brandrup-Wognsen G, et al. The importance of grade 2 ischemic mitral regurgitation in coronary artery bypass grafting. Eur J Cardio-thorac Surg, 2001, 20(2):276-281.
27. Aklog L, Filsoufi F, Flores KQ, et al. Does coronary artery bypass grafting alone correct moderate ischemic mitral regurgitation? Circulation, 2001, 104(suppl 1):I68-I75.
28. Kim YH, Czer LSC, Soukiasian HJ, et al. Ischemic mitral regurgitation:revascularization alone versus revascularization and mitral valve repair. Ann Thorac Surgery, 2005, 79(6):1895-1901.
29. Chan KMJ, Punjabi PP, Flather M, et al. Coronary artery bypass surgery with or without mitral valve annuloplasty in moderate functional ischemic mitral regurgitation final results of the randomized ischemic mitral evaluation (RIME) trial. Circulation, 2012, 126(21):2502-2510.
30. Sá MP, Soares EF, Santos CA, et al. Mitral valve replacement combined with coronary artery bypass graft surgery in patients with moderate-to-severe ischemic mitral regurgitation. Revista Portuguesa de Cardiologia, 2013, 32(2):131-137.
31. Antonio L, Antonio M, Egidio V, et al. Mitral valve repair versus replacement in patients with ischaemic mitral regurgitation and depressed ejection fraction:risk factors for early and mid-term mortality(aEuro). Interact Cardiovasc Thorac Surg, 2014, 19(1):64-69.
32. Dayan V, Soca G, Cura L, et al. Similar survival after mitral valve replacement or repair for ischemic mitral regurgitation:a meta-analysis. Ann Thorac Surg, 2014, 97(3):758-765.
33. 邱志兵, 陈鑫, 徐明, 等. Ⅲb型缺血性二尖瓣反流外科治疗方式的早期临床效果及中远期疗效比较.中国胸心血管外科临床杂志, 2015, 22(9):831-836.
34. Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease (version 2012). Revista Española de Cardiología, 2013, 66(2):131-131.
35. Bonow RO, Carabello BA, Chatterjee K, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol, 2006, 48(3):e1-e148.
36. Khan SS, Trento A, DeRobertis M, et al. Twenty-year comparison of tissue and mechanical valve replacement. J thorac cardiovasc surg, 2001, 122(2):257-269.
37. Deja M A, Grayburn PA, Sun B, et al. Influence of mitral regurgitation repair on survival in the surgical treatment for ischemic heart failure trial. Circulation, 2012, 125(21):2639-2648.
38. Kwon MH, Cevasco M, Chen FY. Functional, ischemic MR:to repair or not to repair? Circulation, 2012:CIRCULATIONAHA. 112.107805.
39. McGee EC, Gillinov AM, Blackstone EH, et al. Recurrent mitral regurgitation after annuloplasty for functional ischemic mitral regurgitation. J Thorac Cardiovasc Surg, 2004, 128(6):916-924.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Progress in Surgical Treatment of Ischemic Mitral Regurgitation

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