(Circulation. 1995;91:1022-1028.)
© 1995 American Heart Association, Inc.
Articles |
Valve Repair Improves the Outcome of Surgery for Mitral Regurgitation
A Multivariate Analysis
From the Division of Cardiovascular Diseases and Internal Medicine (M.E.-S., A.J.T., R.L.F.), Section of Cardiovascular Surgery (H.V.S., T.A.O.), and Section of Biostatistics (K.R.B.), Mayo Clinic and Mayo Foundation, Rochester, Minn.
 |
Abstract |
|---|
 Top Abstract IntroductionMethods Results Discussion References |
|---|
Background Mitral valve repair has been suggested as providing a better postoperative outcome than valve replacement for mitral regurgitation, but this impression has been obscured by differences in baseline characteristics and has not been confirmed in multivariate analyses.
Methods and Results The outcomes in 195 patients with valve repair and 214 with replacement for organic mitral regurgitation were compared using multivariate analysis. All patients had preoperative echocardiographic assessment of left ventricular function. Before surgery, patients with valve repair were less symptomatic than those with replacement (42% in New York Heart Association functional class I or II versus 24%, respectively; P=.001), had less atrial fibrillation (41% versus 53%; P=.017), and had a better ejection fraction (63±9% versus 60±12%, P=.016). After valve repair, compared with valve replacement, overall survival at 10 years was 68±6% versus 52±4% (P=.0004), overall operative mortality was 2.6% versus 10.3% (P=.002), operative mortality in patients under age 75 was 1.3% versus 5.7% (P=.036), and late survival (in operative survivors) at 10 years was 69±6% versus 58±5% (P=.018). Late survival after valve repair was not different from expected survival. After surgery, ejection fraction decreased significantly in both groups but was higher after valve repair (P=.001). Multivariate analysis indicated an independent beneficial effect of valve repair on overall survival (hazard ratio, 0.39; P=.00001), operative mortality (odds ratio, 0.27; P=.026), late survival (hazard ratio, 0.44; P=.001), and postoperative ejection fraction (P=.001).
Conclusions Valve repair significantly improves postoperative outcome in patients with mitral regurgitation and should be the preferred mode of surgical correction. The low operative mortality is an incentive for early surgery before ventricular dysfunction occurs.
Key Words: mitral valve • prognosis • ventricles • myocardium • surgery
|
Introduction |
|---|
|
TopAbstractIntroductionMethods Results Discussion References |
|---|
Since the early days of cardiac surgery,1 2 3 4 the repair of regurgitant mitral valves has been pioneered with the perception that maintaining the normal architecture of the mitral valve is beneficial to the patient.5 However, the clinical suggestion that valve repair, compared with valve replacement, improves postoperative survival6 7 8 9 10 11 and left ventricular function12 13 14 has been obscured by differences in baseline characteristics among the patients treated by the two methods14 15 16 17 and has not been confirmed by multivariate analysis.15 16 Moreover, comparison between repair and replacement has been hindered by the limited number of repairs involved15 16 and by the failure to consider important predictors of outcome such as preoperative left ventricular function.18 19 20 Thus, the clinical impact of valve repair has remained uncertain as has, therefore, its potential as the preferred surgical method of correction of mitral regurgitation. Accordingly, we examined the outcome after valve repair and valve replacement in patients with mitral regurgitation in whom preoperative left ventricular function could be assessed echocardiographically, having hypothesized that mitral valve repair improves operative mortality, late survival, and postoperative residual left ventricular function compared with mitral valve replacement.
|
Methods |
|---|
|
TopAbstractIntroductionMethods Results Discussion References |
|---|
The present study was based on a review of our experience with valve repair and valve replacement for the surgical correction of mitral regurgitation.
Included in the study were patients who had repair or replacement of the mitral valve performed between January 1, 1980, and December 31, 1989; who had acquired organic mitral regurgitation as defined by echocardiographic and surgical assessment; and who had preoperative (within 6 months before surgery) echocardiography allowing at least the assessment of the left ventricular ejection fraction.
Excluded were patients who had previous mitral regurgitation surgery, who had had previous or associated aortic or tricuspid valve replacement (patients with tricuspid valve repair were not excluded), and who had mitral regurgitation of ischemic or functional cause. However, patients with associated coronary artery bypass graft surgery were not excluded.
During that period, 2183 patients had mitral valve surgery at our institution. Of these, 654 had had isolated mitral regurgitation, and 409 of that group had had organic mitral regurgitation and a preoperative echocardiogram. Of the 409, 195 had valve repair and 214 had valve replacement. The clinical follow-up was 98% complete up to 1992 or death. Complications were defined as previously described.21
Echocardiographic Examination
An echocardiographic
examination was performed at a mean of
24±31 days before surgery and was analyzed as described
previously.22 The left ventricular diameters and wall
thicknesses were measured, and the ratio of diameter to wall thickness
was calculated at end diastole and systole. Ejection fraction was
estimated by the consensus of two observers using all parasternal and
apical views of the left ventricle23 in all cases. This
estimation was combined with calculations24 using left
ventricular diameters in 322 patients and was used in isolation in 87
patients. The values of ejection fraction used in the present
analysis were electronically transferred, as noted in the original
report, without alterations. Left atrial diameter was measured in
systole. With the use of noninvasive blood pressure determinations, we
estimated the end-systolic pressure,25 and the
end-systolic wall stress was calculated as previously
described.26
Left Ventricular Angiography
Left ventricular ejection
fraction was measured by angiography
in 219 patients. Correlations with echocardiographic values were
acceptable for routine measurements (r=.61 overall,
r=.70 in patients without coronary disease).
Surgical Procedure
Surgical repair of the mitral valve
involved subvalvular,
valvular (mostly resection or plication), and annular interventions as
previously described.10 27 28 The lesions
repaired
compared with those replaced involved degenerative changes in 170
versus 141 patients and were endocarditic in 11 versus 29 patients,
rheumatic in 8 versus 34 patients, and miscellaneous lesions in 6
versus 10 patients, respectively (P<.0001). A valvular
prolapse was repaired in 183 patients, involving the posterior leaflet
in 128, the anterior leaflet in 20, and both leaflets in 35. Ruptured
chordae were present in 145 of the 195 repair procedures. The
prostheses used in valve replacement were Starr-Edwards (84), disk
prostheses (18), St Jude (8), Ionescu-Shiley (28), Carpentier-Edwards
(72), and Hancock (4). Coronary artery bypass grafting was performed in
99 patients—57% of 195 patients (29%) with valve repair and 42 of
214 patients (20%) with valve replacement (P=.024).
Statistical Analysis
Group statistics were expressed as
mean±1 SD. Group comparisons
were performed with a standard t test or
2 test when appropriate. The cumulative
probability of survival was estimated by the Kaplan-Meier method. The
survival curves of the patients were compared in each group with the
expected survival based on age- and sex-matched actuarial data from the
1980 US white population and tested with the one-sample log-rank test.
Unadjusted group survival comparisons were based on the two-sample
log-rank test. Multivariate analysis for each end point was
performed stepwise for clinical and echocardiographic parameters. Year
of surgery was included to allow for the possibility of confounding
treatment strategy with temporal improvements. Then, the operative
variables (method of correction of the mitral regurgitation, expressed
as repair or replacement of the valve, and the associated coronary
artery bypass graft surgery procedures) were added to the models. A
similar stepwise procedure was used, incorporating the angiographic
ejection fraction instead of its echocardiographic counterpart. The end
points were overall survival, operative mortality, late survival of
operative survivors, and postoperative ejection fraction. Adjusted
group survival comparisons were done with the Cox proportional hazards
models. Operative mortality comparisons were adjusted in a multivariate
logistic analysis. Postoperative ejection fraction comparisons were
adjusted via multiple linear regression. The variables included in the
multivariate analyses are listed in Table 1
. The changes
in ejection fraction from the preoperative to the postoperative period
were compared with a paired t test. A value of
P<.05 was considered significant.
|
|
Results |
|---|
|
TopAbstractIntroductionMethods Results Discussion References |
|---|
The strategy of the analysis was to compare the valve repair group with the valve replacement group regarding baseline characteristics of the patients, overall survival, operative survival, late survival, postoperative ejection fraction, and other end points.
Baseline Characteristics
The preoperative baseline
characteristics of the two groups are
summarized in Table 2. The results show multiple
significant differences, mostly consistent with a better prognosis in
patients with valve repair.
|
Overall Survival
The overall survival after valve repair was
significantly superior
to that after valve replacement (P=.0004), with 5- and
10-year survival rates, respectively, of 83±3% and 68±6%
(repair)
compared with 69±3% and 52±4% (replacement). The survival curves
of
the two groups and the expected survival are presented in Fig
1. At 10 years, the survival after valve repair
represents 100% (P=.64) of the expected survival,
and after replacement it is 77% (P=.0001) of expected. With
multivariate analysis, valve repair was an independent favorable
predictor of overall survival (P=.00001; hazard ratio, 0.39;
95% confidence interval, 0.26 to 0.60) (Table 3). The
survival after valve repair was better than after valve replacement
also when stratified in patients with (at 6 years, 74±6% and
34±8%;
P=.0002) and without (at 5 years, 87±3% and
73±3%; at 10
years, 73±7% and 61±5%; P=.006) coronary artery
bypass
graft surgery (Fig 2). The multivariate model using
angiographic ejection fraction confirmed the independent favorable
impact of valve repair (P=.0018). The other predictors were
age (P=.0001), coronary artery bypass surgery
(P=.0026), creatinine level (P=.03), and
angiographic ejection fraction (P=.08).
|
|
|
Operative Mortality
Operative death was defined as a death
occurring within 1 month of
surgery or during the same hospitalization. Operative death occurred in
5 of the 195 patients with valve repair (2.6%) compared with 22 of 214
patients with valve replacement (10.3%) (P=.002) (Table
4). With multivariate analysis, valve repair was an
independent favorable predictor of operative mortality
(P=.026; odds ratio, 0.27; 95% confidence interval, 0.09 to
0.86) (Table 3
). Operative mortality in relation to age is
presented in Table 4.
|
Late Survival
Late survival was analyzed in 375 patients,
excluding 27 operative
deaths and 7 patients lost to follow-up. The causes of late death in
valve repair and replacement were, respectively, coronary disease in 4
and 10 patients, left ventricular dysfunction (through sudden death or
congestive heart failure) in 9 and 27, valvular complications in 8 and
17, noncardiac causes in 6 and 8, and unknown causes in 2 and 4. Late
survival was significantly better after valve repair than after valve
replacement (P=.018) at 5 and 10 years: 85±3% and
69±6%
for repair and 77±3% and 58±5% for replacement, respectively. At
10
years, the late survival of the valve repair group
represented 100% (P=.77) of the expected
survival as compared with 83% (P<.0001) in the replacement
group. The late survival curves of the repair and replacement groups
are presented in Fig 3. With multivariate
analysis, valve repair was an independent favorable determinant of
late survival (P=.001; hazard ratio, 0.44; 95% confidence
interval, 0.27 to 0.73) (Table 3). The incidence of left
ventricular
dysfunction-related deaths was lower in the valve repair than in the
valve replacement group (log rank P=.036).
|
Left Ventricular Function
The postoperative left ventricular
ejection fraction was measured
in 315 patients 2.7±2.9 years after surgery—177 with valve repair
and
138 with valve replacement. Preoperative characteristics were not
different between patients with and those without postoperative
echocardiograms, showing that those with postoperative ejection
fraction were representative of the overall population
regardless of whether a repair or replacement was performed. Ejection
fraction remained stable with time in patients with multiple
postoperative echocardiograms. Overall, there was a decrease in
ejection fraction after surgery, from 62±10% to 52±13%
(P=.0001). A significant decrease in the ejection fraction
was observed in both groups: for valve repair, 63±9% to 54±11%
(P=.0001), and for valve replacement, 60±12% to
49±15%
(P=.0001). Ejection fraction was significantly higher in the
valve repair group than in the valve replacement group both before
(P=.016) and after surgery (P=.001) (Fig
4). Although absolute differences were modest with
multivariate analysis, valve repair was an independent predictor of
higher postoperative ejection fraction (P=.001; odds ratio
of ejection fraction 
50%, 2.72; 95% confidence interval, 1.43 to
5.16) (Table 3).
|
Other End Points
There was no significant difference between
valve repair and valve
replacement groups regarding the need for reoperation (free of
reoperation: at 5 years, 90±2.5% and 93±2%; at 10 years,
75±10%
and 80±6%, respectively; P=.47) (Fig 5),
the incidence of thromboembolism (at 10 years, 68±8% and 70±4%
were
free of thromboembolism, respectively; P=NS), and the
incidence of bacterial endocarditis (at 10 years, 92±5% and
97±1%
were free of endocarditis, respectively; P=NS). However,
patients with valve repair had a lower incidence of coumadin treatment
(n=64, or 33%, compared with n=141, or 66%, in valve
replacement;
P=.0001) and of significant hemorrhage (at 10 years,
88±3%
in the valve repair group and 73±4% in the valve replacement group
were free of significant hemorrhage; P=.002).
|
|
Discussion |
|---|
|
TopAbstractIntroductionMethods Results Discussion References |
|---|
In the present series of 195 valve repairs and 214 valve replacements performed for organic mitral regurgitation, there are differences in baseline characteristics between the two groups, but multivariate analysis confirms that valve repair is an independent determinant of improved operative and late survival and of improved left ventricular function.
Beneficial Results of Valve Repair Compared With Valve
Replacement
In patients with mitral stenosis, conservative
surgery—that is,
commissurotomy—provides both low operative risk and excellent late
survival, with a low incidence of valve-related
complications.28 These results are at variance with those
obtained with valve replacement.29 Thus, in this setting,
conservative surgery, if feasible, has always been the preferred
option. Conservative surgery (valve repair) has also been attempted for
mitral regurgitation since the early days of cardiac
surgery,1 2 3 4 but the
results have been more
inconsistent30 31 32 33
because the lesions of mitral
regurgitation are more complex and difficult to correct.34
The techniques of repair of regurgitant lesions have progressively
improved,35 36 and with the decrease in rheumatic
valve
disease37 they are now widely applied in the large
population with degenerative mitral valve
disease.10 37 38 39 40
The durability of valve repair also has been well
demonstrated.41 42 43
However, valve repair can be difficult,44 and its superiority to prosthetic replacement has not been firmly established15 16 44 45 because of small sample sizes45 and of differences in baseline characteristics of patients14 15 16 17 that suggest that surgery was performed at an earlier stage in valve repair than in valve replacement. It has remained uncertain, therefore, whether the observed differences in outcome are related to the method of correction of the mitral regurgitation or to a more favorable clinical situation existing before surgery. Matching identical patients who have had either valve repair or replacement has been attempted,19 45 but this method is selective and has its drawbacks. Thus, the best way of addressing the issue of nonuniformity of the groups is to perform multivariate analyses that include the most important prognostic indicators. When this type of analysis was performed in other studies, however, it did not show a significant independent prognostic impact of valve repair.15 16 In contrast, the present study demonstrates that the method of correction is indeed an independent determinant of the observed differences in survival after valve repair in comparison with valve replacement. The large number of repairs, the homogeneity of the patient population, and the preoperative assessment of left ventricular function probably contribute to the statistical power of the present series.
Mechanism of Improved Outcome
The lower operative mortality
after valve repair in the
present study is consistent with previous
observations,9 but the mechanism has not been fully
understood. However, since left ventricular dysfunction is the major
cause of late death after mitral valve surgery,46 the
lower mortality rate in patients with valve repair is readily
understandable: after valve repair, postoperative ejection fraction is
significantly higher than after valve replacement, and the incidence of
death due to left ventricular dysfunction is reduced. Although this
phenomenon is in part related to a better preoperative function, it
also is an intrinsic effect of valve repair. Improvement in left
ventricular function was previously suggested, mainly on the basis of
small series,13 14 but in the present study,
postoperative echocardiograms were available in 315 of the 409 patients
to conclusively confirm this improvement.
The role of the conservation of the normal mitral apparatus architecture in the preservation of left ventricular function has been underlined experimentally47 48 as well as clinically,14 49 50 51 even in association with mitral valve replacement. The better postoperative left ventricular function is not related to a higher left ventricular mass in patients with valve repair.52 Instead, it has been suggested that the geometry of the left ventricle is more favorable25 in association with conservation of the mitral architecture, leading to a reduction in wall stress that may allow more favorable remodeling of the ventricle after correction of the regurgitation.
It is to be noted, however, that ejection fraction decreases after valve repair53 and that the difference with valve replacement is only a matter of the magnitude of the left ventricular response to surgery. Thus, the ability to perform valve repair should not allow one to disregard a potential left ventricular dysfunction. This complication is associated with poor postoperative prognosis18 19 46 and is not eradicated by performance of valve repair. The prognostic value of the preoperative echocardiographic ejection fraction is significant in patients with valve repair as well as in those with valve replacement20 and should be taken into account in the clinical decision-making process.
The improved outcome after valve repair is not obtained at the expense of an increase in valve-related complications. In particular, the incidence of reoperation does not significantly differ between valve repair and replacement. Furthermore, the incidence of significant hemorrhage is decreased with valve repair, another feature explaining the lower number of valve-related deaths.
New improvements should extend the field of application of mitral valve repair. Artificial chordae and transposition of chordae35 36 are now available for flail anterior leaflets, which were, until recently, more difficult to repair than flail posterior leaflets. Also, the addition of intraoperative transesophageal echocardiography has made it possible to detect, and immediately correct, unsatisfactory repairs.54 55
Potential Limitations
The use of echocardiography may raise
concern. However, all the
reported measurements were directed by two-dimensional
echocardiography, and the assessment of ejection fraction by this
methodology has not only been validated23 24 but also
has
shown acceptable correlations to angiography in our routine experience,
and the high degree of reproducibility56 and the value of
the visual estimate57 58 have been confirmed.
Moreover,
the most significant test of validity of a technique resides in its
prognostic power. In patients with mitral regurgitation,
echocardiographic ejection fraction is the most powerful predictor of
postoperative left ventricular function46 and
survival.20 After surgery, the paradoxic septal motion
associated with cardiac surgery has been shown to be a translational
movement59 rather than a regional wall motion abnormality,
and it does not impair the ability to assess postoperative left
ventricular function by echocardiography. Furthermore, the
postoperative left ventricular function shows no systematic trend for
improvement or deterioration with time,46 and consequently
the timing of measurement of the postoperative ejection fraction does
not have an impact on the results and on the fact that postoperative
left ventricular function is better preserved after valve repair than
after replacement. The fact that not all patients could have an
assessment of postoperative ejection fraction has been encountered even
in prospective studies,18 but these patients were similar
to the patients without postoperative echocardiograms and thus were
representative of the overall population in the present
study.
The fact that baseline characteristics are different between the two groups of patients may be considered a limitation but is the precise reason why the superiority of valve repair over valve replacement remained uncertain.15 16 Because a randomized trial has never been performed and may not be feasible, the only presently acceptable method of comparison of the two surgical procedures is to adjust for the baseline outcome predictors in multivariate analysis, as was performed in the present study.
Clinical Implications
The present series of 195 valve repairs
and 214 valve
replacements shows that after adjustment for all confounding variables,
valve repair is a strong independent predictor of improved survival and
postoperative left ventricular function, without compromise of the
valvular results, in comparison with valve replacement. These data
suggest that valve repair should be the preferred method of correction
of mitral regurgitation and should be considered in all cases in which
surgery is contemplated. The low operative risk of valve repair is an
incentive to consider surgery at an early stage in the course of the
disease before the advent of left ventricular dysfunction.
|
Acknowledgments |
|---|
We acknowledge the expert secretarial assistance of Janet L. Halling, the data abstracting of Kim D. Jones, and the data analysis of Sara L. Fett in the preparation of this manuscript.
|
Footnotes |
|---|
Reprint requests to Maurice Enriquez-Sarano, MD, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
Received May 11, 1994; revision received August 2, 1994; accepted September 13, 1994.
|
References |
|---|
|
TopAbstractIntroductionMethods Results Discussion References |
|---|
1. Lillehei CW, Gott VL, DeWall RA, Varco RL. Surgical correction of pure mitral insufficiency by annuloplasty under direct vision. Lancet. 1957;77:446-449.
2. Guidry LD, Callahan JA, Marshall HW, Ellis FH Jr. The surgical treatment of mitral insufficiency by mitral annuloplasty. Proc Staff Meet Mayo Clin. 1958;33:523-531. [Medline] [Order article via Infotrieve]
3. McGoon DC. Repair of mitral insufficiency due to ruptured chordae tendineae. J Thorac Cardiovasc Surg.1960;39:357-362.
4. Wooler GH, Nixon GF, Grimshaw VA, Watson DA. Experiences with the repair of the mitral valve in mitral incompetence. Thorax. 1962;17:49-57.
5. Carpentier A, Deloche A, Dauptain J, Soyer R, Blondeau P, Piwnica A, Dubost Ch. A new reconstructive operation for correction of mitral and tricuspid insufficiency. J Thorac Cardiovasc Surg. 1971;61:1-13. [Medline] [Order article via Infotrieve]
6. Yacoub M, Halim M, Radley-Smith R, McKay R, Nijveld A, Towers M. Surgical treatment of mitral regurgitation caused by floppy valves: repair versus replacement. Circulation. 1981;65(suppl II):II-210-II-216.
7. Duran CG, Pomar JL, Revuelta JM, Gallo I, Poveda J, Ochoteco A, Ubago J. Conservative operation for mitral insufficiency: critical analysis supported by postoperative hemodynamic studies of 72 patients. J Thorac Cardiovasc Surg. 1989;79:326-337. [Abstract]
8.
Oliveira BDG, Dawkins KD, Kay PH, Paneth M. Chordal rupture:
II, comparison between repair and replacement. Br Heart J. 1983;50:318-324.
9. Perier P, Deloche A, Chauvaud S, Fabiani JN, Rossant P, Bessou JP, et al. Comparative evaluation of mitral valve repair and replacement with Starr, Björk, and porcine valve protheses. Circulation. 1984;70(suppl I):I-187-I-192.
10. Orszulak TA, Schaff HV, Danielson GK, Piehler JM, Pluth JR, Frye RL, McGoon DC, Elveback LR. Mitral regurgitation due to ruptured chordae tendineae: early and late results of valve repair. J Thorac Cardiovasc Surg. 1985;89:491-498. [Abstract]
11. Angell WW, Oury JH, Shah P. A comparison of replacement and reconstruction in patients with mitral regurgitation. J Thorac Cardiovasc Surg. 1987;93:665-674. [Abstract]
12. Boncheck LI, Olinger GN, Siegel R, Tresch DD, Keelan MH Jr. Left ventricular performance after mitral reconstruction for mitral regurgitation. J Thorac Cardiovasc Surg. 1984;88:122-127. [Abstract]
13. Goldman ME, Mora F, Guarino T, Fuster V, Mindich BP. Mitral valvuloplasty is superior to valve replacement for preservation of left ventricular function: an intraoperative two-dimensional echocardiographic study. J Am Coll Cardiol. 1987;10:568-575. [Abstract]
14. Sakai K, Nakano S, Taniguchi K, Sakaki S, Hirata N, Shintani H, Shimazaki Y, Kawashima Y, Matsuda H. Global left ventricular performance and regional systolic function after suture annuloplasty for chronic mitral regurgitation. Circulation. 1992;86(suppl II):II-39-II-45.
15. Sand ME, Naftel DC, Blackstone EH, Kirklin JW, Karp RB. A comparison of repair and replacement for mitral valve incompetence. J Thorac Cardiovasc Surg. 1987;94:208-219. [Abstract]
16. Galloway AC, Colvin SB, Baumann FG, Grossi EA, Ribakove GH, Harty S, Spencer FC. A comparison of mitral valve reconstruction with mitral valve replacement: intermediate-term results. Ann Thorac Surg. 1989;47:655-662. [Abstract]
17. Kawachi Y, Oe M, Asou T, Tominaga R, Tokunaga K. Comparative study between valve repair and replacement for mitral pure regurgitation. Jpn Circ J. 1991;55:443-452. [Medline] [Order article via Infotrieve]
18.
Crawford MN, Souchek J, Oprian CA, Miller DC,
Rahimtoola S, Giacomini JC, Sethi G, Hammermeister KE, and Participants
in the Department of Veterans Affairs Cooperative Study on Valvular
Heart Disease. Determinants of survival and left ventricular
performance after mitral valve replacement.
Circulation. 1990;81:1173-1181.
19. Zile MR, Gaasch WH, Carroll JD, Levine HJ. Chronic mitral regurgitation: predictive value of preoperative echocardiographic indexes of left ventricular function and wall stress. J Am Coll Cardiol. 1984;3:235-242. [Abstract]
20. Enriquez-Sarano M, Tajik AJ, Schaff HV, Orszulak TA, Bailey KR, Frye RL. Echocardiographic prediction of survival after surgical correction of organic mitral regurgitation. Circulation. 1994;90: 830-837.
21. Edmunds LH Jr, Clark RE, Cohn LH, Miller DC, Weisel RD. Guidelines for reporting morbidity and mortality after cardiac valvular operations. Ann Thorac Surg. 1988;46:257-259. [Medline] [Order article via Infotrieve]
22. Tajik AJ, Seward JB, Hagler DJ, Mair DD, Lie JT. Two-dimensional real-time ultrasonic imaging of the heart and great vessels: technique, image orientation, structure identification, and validation. Mayo Clin Proc. 1978;53:271-303. [Medline] [Order article via Infotrieve]
23.
Quinones MA, Pickering E, Alexander JK. Percentage of
shortening of the echocardiographic left ventricular dimension: its use
in determining ejection fraction and stroke volume. Chest. 1978;74:59-65.
24. Rich S, Shiekh A, Gallastegui J, Kondos GT, Mason T, Lam W. Determination of left ventricular ejection fraction by visual estimation during real-time two-dimensional echocardiography. Am Heart J. 1982;104:603-606. [Medline] [Order article via Infotrieve]
25.
Rozich JDE, Carabello BA, Usher BW, Kratz JM, Bell AE, Zile
MR. Mitral valve replacement with and without chordal preservation in
patients with chronic mitral regurgitation: mechanisms for differences
in postoperative ejection performance.
Circulation. 1992;86:1718-1726.
26.
Reichek N, Wilson J, St. John Sutton M, Plappert TA, Goldberg
S, Hirshfeld JW. Noninvasive determination of left ventricular
end-systolic stress: validation of the method and initial application.
Circulation. 1982;65:99-108.
27. Carpentier A, Relland J, Deloche A, Fabiani J-N, D'Allaines C, Blondeau P, Piwnica A, Chauvaud S, Dubost C. Conservative management of the prolapsed mitral valve. Ann Thorac Surg. 1978;26:294-302. [Abstract]
28. Carpentier A. Cardiac valve surgery—the `French correction.' J Thorac Cardiovasc Surg. 1983;86:323-337. [Medline] [Order article via Infotrieve]
29. Cohn LH, Allred EN, Cohn LA, Austin JC, Sabik J, DiSesa VJ, Shemin RJ, Collins JJ Jr. Early and late risk of mitral valve replacement: a 12 year concomitant comparison of the porcine bioprosthetic and prosthetic disc mitral valves. J Thorac Cardiovasc Surg. 1985;90:872-881. [Abstract]
30. Ellis FH Jr, Frye RL, McGoon DC. Results of reconstructive operations for mitral insufficiency due to ruptured chordae tendineae. Surgery. 1966;59:165-172. [Medline] [Order article via Infotrieve]
31. Antunes MJ, Magalhaes MP, Colsen PR, Kinsley RH. Valvuloplasty for rheumatic mitral valve disease: a surgical challenge. J Thorac Cardiovasc Surg. 1987;94:44-56. [Abstract]
32. Lessana A, Carbone C, Romano M, Palsky E, Quan YH, Escorsin M, Jegier B, Ruffenach A, Lutfalla G, Aime F, Guerin F. Mitral valve repair: results and the decision-making process in reconstruction: report of 275 cases. J Thorac Cardiovasc Surg. 1990;99:622-630. [Abstract]
33. Niederhäuser U, Carrel T, von Segesser LK, Laske A, Turina M. Reoperation after mitral valve reconstruction: early and late results. Eur J Cardiothorac Surg. 1993;7:34-37. [Abstract]
34. Marwick TH, Stewart WJ, Currie PJ, Cosgrove DM. Mechanisms of failure of mitral valve repair: an echocardiographic study. Am Heart J. 1991;122:149-156. [Medline] [Order article via Infotrieve]
35. Frater RWM, Gabbay S, Shore D, Factor S, Strom J. Reproducible replacement of elongated or ruptured mitral valve chordae. Ann Thorac Surg. 1983;35:14-28. [Abstract]
36. Lessana A, Escorsin M, Romano M, Ades F, Vergoni W, Lorenzoni D, Menozzi C, Monducci I. Transposition of posterior leaflet for treatment of ruptured main chordae of the anterior mitral leaflet. J Thorac Cardiovasc Surg. 1985;89:804-806. [Abstract]
37. Cosgrove DM, Chavez AM, Lytle BW, Gill CC, Stewart RW, Taylor PC, Goormastic M, Borsh JA, Loop FD. Results of mitral valve reconstruction. Circulation. 1986;74(suppl I):I-82-I-87.
38. Cohn LH, DiSesa VJ, Couper GS, Peigh PS, Kowalker W, Collins JJ Jr. Mitral valve repair for myxomatous degeneration and prolapse of the mitral valve. J Thorac Cardiovasc Surg. 1989;98:987-993. [Abstract]
39. Penkoske PA, Ellis FH Jr, Alexander S, Watkins E Jr. Results of valve reconstruction for mitral regurgitation secondary to mitral valve prolapse. Am J Cardiol. 1985;55:735-738. [Medline] [Order article via Infotrieve]
40. David TE, Armstrong S, Sun Z, Daniel L. Late results of mitral valve repair for mitral regurgitation due to degenerative disease. Ann Thorac Surg. 1993;56:7-14. [Abstract]
41. Deloche A, Jebara VA, Relland JY, Chauvaud S, Fabiani JN, Perier P, Dreyfus G, Mihaileanu S, Carpentier A. Valve repair with Carpentier techniques: the second decade. J Thorac Cardiovasc Surg. 1990;99:990-1002. [Abstract]
42. Durán CG, Revuelta JM, Gaite L, Alonso C, Fleitas MG. Stability of mitral reconstructive surgery at 10-12 years for predominantly rheumatic valvular disease. Circulation. 1988;78(pt 2):I-91-I-96.
43. Galloway AC, Colvin SB, Baumann FG, Esposito R, Vohra R, Harty S, Freedberg R, Kronzon I, Spencer FC. Long-term results of mitral valve reconstruction with Carpentier techniques in 148 patients with mitral insufficiency. Circulation. 1988;78(pt 2):I-97-I-105.
44. Cohn LH, Kowalker W, Bhatia S, DiSesa VJ, St. John-Sutton M, Shemin RJ, Collins JJ Jr. Comparative morbidity of mitral valve repair versus replacement for mitral regurgitation with and without coronary artery disease. Ann Thorac Surg. 1988;45:284-290. [Abstract]
45. Craver JM, Cohen C, Weintraub WS. Case-matched comparison of mitral valve replacement and repair. Ann Thorac Surg. 1990;49: 964-969.
46. Enriquez-Sarano M, Tajik AJ, Schaff HV, Orszulak TA, McGoon MD, Bailey KR, Frye RL. Echocardiographic prediction of left ventricular function after correction of mitral regurgitation: results and clinical implications. J Am Coll Cardiol. 1994;24:1536-1543. [Abstract]
47.
Hansen DE, Cahill PD, DeCampli WM, Harrison DC, Derby GC,
Mitchell RS, Miller DC. Valvular-ventricular interaction: importance of
the mitral apparatus in canine left ventricular systolic performance.
Circulation. 1986;73:1310-1320.
48. Spence PA, Peniston CM, David TE, Mihic N, Jabr AK, Narini P, Salerno TA. Toward a better understanding of the etiology of left ventricular dysfunction after mitral valve replacement: an experimental study with possible clinical implications. Ann Thorac Surg. 1986;41:363-371. [Abstract]
49. Pitarys CJ II, Forman MB, Panayiotou H, Hansen DE. Long-term effects of excision of the mitral apparatus on global and regional ventricular function in humans. J Am Coll Cardiol. 1990;15:557-563. [Abstract]
50. David TE, Uden DE, Strauss HD. The importance of the mitral apparatus in left ventricular function after correction of mitral regurgitation. Circulation. 1983;68(suppl II):II-76-II-82.
51. Hennein HA, Swain JA, McIntosh CL, Bonow RO, Stone CD, Clark RE. Comparative assessment of chordal preservation versus chordal resection during mitral valve replacement. J Thorac Cardiovasc Surg. 1990;99:828-837. [Abstract]
52. Sim EKW, Orszulak TA, Sarano ME. The quality not quantity of muscle is the determinant of LV function following mitral valve surgery. Circulation. 1993;88(Part 2):I-59. Abstract.
53. Lessana A, Herreman F, Boffety C, Cosma H, Guerin F, Kara M, Degeorges M. Hemodynamic and cineangiographic study before and after mitral valvuloplasty (Carpentier's technique). Circulation. 1981;64(suppl II):II-195-II-202.
54. Goldman ME, Fuster V, Guarino T, Mindich BP. Intraoperative echocardiography for the evaluation of valvular regurgitation: experience in 263 patients. Circulation. 1986;74(suppl I):I-143-I-149.
55. Freeman WK, Schaff HV, Khandheria BK, Oh JK, Orszulak TA, Abel MD, Seward JB, Tajik AJ. Intraoperative evaluation of mitral valve regurgitation and repair by transesophageal echocardiography: incidence and significance of systolic anterior motion. J Am Coll Cardiol. 1992;20:599-609. [Abstract]
56. Fast J, Jacobs S. Limits of reproducibility of cross-sectional echocardiographic measurement of left ventricular ejection fraction. Int J Cardiol. 1990;28:67-72. [Medline] [Order article via Infotrieve]
57. Amico AF, Lichtenberg GS, Reisner SA, Stone CK, Schwartz RG, Meltzer RS. Superiority of visual versus computerized echocardiographic estimation of radionuclide left ventricular ejection fraction. Am Heart J. 1989;118:1259-1265. [Medline] [Order article via Infotrieve]
58. Mueller X, Stauffer JC, Jaussi A, Goy JJ, Kappenberger L. Subjective visual echocardiographic estimate of left ventricular ejection fraction as an alternative to conventional echocardiographic methods: comparison with contrast angiography. Clin Cardiol. 1991;14:898-902. [Medline] [Order article via Infotrieve]
59.
Lehmann KG, Lee FA, McKenzie WB, Barash PG, Prokop EK, Durkin
MA, Ezekowitz MD. Onset of altered interventricular septal motion
during cardiac surgery: assessment by continuous intraoperative
transesophageal echocardiography. Circulation. 1990;82:1325-1334.
This article has been cited by other articles:
 |
|
 |
|
  J. Kempfert, J. Blumenstein, M. W.A. Chu, P. Pritzwald-Stegmann, T. Kobilke, V. Falk, F. W. Mohr, and T. Walther Minimally invasive off-pump valve-in-a-ring implantation: the atrial transcatheter approach for re-operative mitral valve replacement after failed repair Eur. J. Cardiothorac. Surg., June 1, 2009; 35(6): 965 - 969. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. El Oumeiri, M. Boodhwani, D. Glineur, L. De Kerchove, A. Poncelet, P. Astarci, A. Pasquet, J.-L. Vanoverschelde, R. Verhelst, J. Rubay, et al. Extending the Scope of Mitral Valve Repair in Rheumatic Disease. Ann. Thorac. Surg., June 1, 2009; 87(6): 1735 - 1740. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Piazza, A. Asgar, R. Ibrahim, and R. Bonan Transcatheter Mitral and Pulmonary Valve Therapy J. Am. Coll. Cardiol., May 19, 2009; 53(20): 1837 - 1851. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Gammie, S. Sheng, B. P. Griffith, E. D. Peterson, J. S. Rankin, S. M. O'Brien, and J. M. Brown Trends in mitral valve surgery in the United States: results from the Society of Thoracic Surgeons Adult Cardiac Surgery Database. Ann. Thorac. Surg., May 1, 2009; 87(5): 1431 - 1437. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Papadopoulos, M. Dietrich, T. Christodoulou, A. Moritz, and M. Doss Midterm Survival After Decalcification of the Mitral Annulus Ann. Thorac. Surg., April 1, 2009; 87(4): 1143 - 1147. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D.-H. Kang, J. H. Kim, J. H. Rim, M.-J. Kim, S.-C. Yun, J.-M. Song, H. Song, K.-J. Choi, J.-K. Song, and J.-W. Lee Comparison of Early Surgery Versus Conventional Treatment in Asymptomatic Severe Mitral Regurgitation Circulation, February 17, 2009; 119(6): 797 - 804. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. S. McClure, L. H. Cohn, E. Wiegerinck, G. S. Couper, S. F. Aranki, R. M. Bolman III, M. J. Davidson, and F. Y. Chen Early and late outcomes in minimally invasive mitral valve repair: an eleven-year experience in 707 patients. J. Thorac. Cardiovasc. Surg., January 1, 2009; 137(1): 70 - 75. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Tanne, L. Kadem, R. Rieu, and P. Pibarot Hemodynamic impact of mitral prosthesis-patient mismatch on pulmonary hypertension: an in silico study J Appl Physiol, December 1, 2008; 105(6): 1916 - 1926. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Zegdi, G. Sleilaty, C. Latremouille, A. Berrebi, A. Carpentier, A. Deloche, and J.-N. Fabiani Reoperation for Failure of Mitral Valve Repair in Degenerative Disease: A Single-Center Experience Ann. Thorac. Surg., November 1, 2008; 86(5): 1480 - 1484. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
2006 WRITING COMMITTEE MEMBERS, R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, et al. 2008 Focused Update Incorporated Into the 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): Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons Circulation, October 7, 2008; 118(15): e523 - e661. [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. 2008 Focused Update Incorporated Into the 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) Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons J. Am. Coll. Cardiol., September 23, 2008; 52(13): e1 - e142. [Full Text] [PDF]
|
|
|
|
|
|
R. M. Suri, H. V. Schaff, J. A. Dearani, T. M. Sundt III, R. C. Daly, C. J. Mullany, M. E. Sarano, and T. A. Orszulak Determinants of early decline in ejection fraction after surgical correction of mitral regurgitation. J. Thorac. Cardiovasc. Surg., August 1, 2008; 136(2): 442 - 447. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. A. Carabello The Current Therapy for Mitral Regurgitation J. Am. Coll. Cardiol., July 29, 2008; 52(5): 319 - 326. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Ailawadi, B. R. Swenson, M. E. Girotti, L. M. Gazoni, B. B. Peeler, J. A. Kern, L. M. Fedoruk, and I. L. Kron Is Mitral Valve Repair Superior to Replacement in Elderly Patients? Ann. Thorac. Surg., July 1, 2008; 86(1): 77 - 86. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. K. Song, J. D. Grab, S. M. O'Brien, K. F. Welke, F. Edwards, and R. M. Ungerleider Gender Differences in Mortality After Mitral Valve Operation: Evidence for Higher Mortality in Perimenopausal Women Ann. Thorac. Surg., June 1, 2008; 85(6): 2040 - 2045. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. K Reddy, A. K Dharmapuram, S. K Swain, N. Ramdoss, S. S Raghavan, and K. S Murthy Valve Repair in Rheumatic Heart Disease in Pediatric Age Group Asian Cardiovasc Thorac Ann, April 1, 2008; 16(2): 129 - 133. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Russo, F. Grigioni, J.-F. Avierinos, W. K. Freeman, R. Suri, H. Michelena, R. Brown, T. M. Sundt, and M. Enriquez-Sarano Thromboembolic Complications After Surgical Correction of Mitral Regurgitation: Incidence, Predictors, and Clinical Implications J. Am. Coll. Cardiol., March 25, 2008; 51(12): 1203 - 1211. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Grigioni, C. Tribouilloy, J. F. Avierinos, A. Barbieri, M. Ferlito, F. Trojette, L. Tafanelli, A. Branzi, C. Szymanski, G. Habib, et al. Outcomes in mitral regurgitation due to flail leaflets a multicenter European study. J. Am. Coll. Cardiol. Img., March 1, 2008; 1(2): 133 - 141. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. W.M. Fedak, P. M. McCarthy, and R. O. Bonow Evolving Concepts and Technologies in Mitral Valve Repair Circulation, February 19, 2008; 117(7): 963 - 974. [Full Text] [PDF]
|
|
|
|
|
|
W. Flameng, B. Meuris, P. Herijgers, and M.-C. Herregods Durability of mitral valve repair in Barlow disease versus fibroelastic deficiency. J. Thorac. Cardiovasc. Surg., February 1, 2008; 135(2): 274 - 282. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Enriquez-Sarano, V. T. Nkomo, and H. Michelena Principles and Practice of Echocardiography in Cardiac Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 315 - 348. [Full Text]
|
|
|
|
|
|
W. Y. Szeto, R. C. Gorman, J. H. Gorman III, and M. A. Acker Ischemic Mitral Regurgitation Card. Surg. Adult, January 1, 2008; 3(2008): 785 - 802. [Full Text]
|
|
|
|
|
|
H. V. Schaff and R. M. Suri Multiple Valve Disease Card. Surg. Adult, January 1, 2008; 3(2008): 1129 - 1158. [Full Text]
|
|
|
|
 |
|
 G. Gatti, F. Marciano, F. Antonini-Canterin, B. Pinamonti, B. Benussi, A. Pappalardo, and B. Zingone Tricuspid valve annuloplasty with a flexible prosthetic band Interactive CardioVascular and Thoracic Surgery, December 1, 2007; 6(6): 731 - 735. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Timek, S. L. Nielsen, D. T. Lai, D. Liang, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller Effect of Chronotropy and Inotropy on Stitch Tension in the Edge-to-Edge Mitral Repair Circulation, September 11, 2007; 116(11_suppl): I-276 - I-281. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K.S Kunzelman, D.R Einstein, and R.P Cochran Fluid-structure interaction models of the mitral valve: function in normal and pathological states Phil Trans R Soc B, August 29, 2007; 362(1484): 1393 - 1406. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-A. Rey Meyer, L. K. von Segesser, M. Hurni, F. Stumpe, K. Eisa, and P. Ruchat Long-term outcome after mitral valve repair: a risk factor analysis Eur. J. Cardiothorac. Surg., August 1, 2007; 32(2): 301 - 307. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Morimoto, K. Tsuchiya, M. Nakajima, O. Akashi, and K. Kato Mitral Valve Repair for Extended Commissural Prolapse Involving Complex Prolapse Asian Cardiovasc Thorac Ann, June 1, 2007; 15(3): 210 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Law and K.-L. Chan Surgical referral in symptomatic mitral regurgitation: greater compliance with guidelines is needed Eur. Heart J., June 1, 2007; 28(11): 1281 - 1282. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Lee and T. H. Marwick Assessment of subclinical left ventricular dysfunction in asymptomatic mitral regurgitation Eur J Echocardiogr, June 1, 2007; 8(3): 175 - 184. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. M. Gazoni, L. M. Fedoruk, J. A. Kern, J. M. Dent, T. B. Reece, C. G. Tribble, P. W. Smith, T. C. Lisle, and I. L. Kron A Simplified Approach to Degenerative Disease: Triangular Resections of the Mitral Valve Ann. Thorac. Surg., May 1, 2007; 83(5): 1658 - 1665. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Coats and P. Bonhoeffer NEW PERCUTANEOUS TREATMENTS FOR VALVE DISEASE Heart, May 1, 2007; 93(5): 639 - 644. [Full Text] [PDF]
|
|
|
|
|
|
R. M. Bolman III Survival After Mitral Valve Replacement: Does the Valve Type and/or Size Make a Difference? Circulation, March 20, 2007; 115(11): 1336 - 1338. [Full Text] [PDF]
|
|
|
|
|
|
J. Magne, P. Mathieu, J. G. Dumesnil, D. Tanne, F. Dagenais, D. Doyle, and P. Pibarot Impact of Prosthesis-Patient Mismatch on Survival After Mitral Valve Replacement Circulation, March 20, 2007; 115(11): 1417 - 1425. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Shuhaiber and R. J. Anderson Meta-analysis of clinical outcomes following surgical mitral valve repair or replacement Eur. J. Cardiothorac. Surg., February 1, 2007; 31(2): 267 - 275. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Brown, M. D. Abel, R. L. Click, R. G. Morford, J. A. Dearani, T. M. Sundt, T. A. Orszulak, and H. V. Schaff Systolic anterior motion after mitral valve repair: Is surgical intervention necessary? J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 136 - 143. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. Murphy, J. S. Miller, D. A. Langford, and A. B. Snyder Endoscopic robotic mitral valve surgery J. Thorac. Cardiovasc. Surg., October 1, 2006; 132(4): 776 - 781. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kuduvalli, S. V. Ghotkar, A. D. Grayson, and B. M. Fabri Edge-to-Edge Technique for Mitral Valve Repair: Medium-Term Results With Echocardiographic Follow-Up. Ann. Thorac. Surg., October 1, 2006; 82(4): 1356 - 1361. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. M. Suri, H. V. Schaff, J. A. Dearani, T. M. Sundt III, R. C. Daly, C. J. Mullany, M. Enriquez-Sarano, and T. A. Orszulak Survival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era. Ann. Thorac. Surg., September 1, 2006; 82(3): 819 - 826. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, 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., August 1, 2006; 48(3): e1 - e148. [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Practice Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary: 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., August 1, 2006; 48(3): 598 - 675. [Full Text] [PDF]
|
|
|
|
|
|
A. Sampath Kumar, S. Talwar, A. Saxena, R. Singh, and D. Velayoudam Results of mitral valve repair in rheumatic mitral regurgitation Interactive CardioVascular and Thoracic Surgery, August 1, 2006; 5(4): 356 - 361. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B Bridgewater, T Hooper, C Munsch, S Hunter, U von Oppell, S Livesey, B Keogh, F Wells, M Patrick, J Kneeshaw, et al. Mitral repair best practice: proposed standards Heart, July 1, 2006; 92(7): 939 - 944. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. P. Griffin Timing of Surgical Intervention in Chronic Mitral Regurgitation: Is Vigilance Enough? Circulation, May 9, 2006; 113(18): 2169 - 2172. [Full Text] [PDF]
|
|
|
|
|
|
R. Rosenhek, F. Rader, U. Klaar, H. Gabriel, M. Krejc, D. Kalbeck, M. Schemper, G. Maurer, and H. Baumgartner Outcome of Watchful Waiting in Asymptomatic Severe Mitral Regurgitation Circulation, May 9, 2006; 113(18): 2238 - 2244. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Kasegawa, T. Shimokawa, I. Shibazaki, H. Hayashi, T. Koyanagi, and T. Ida Mitral valve repair for anterior leaflet prolapse with expanded polytetrafluoroethylene sutures. Ann. Thorac. Surg., May 1, 2006; 81(5): 1625 - 1631. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Aybek, P. Risteski, A. Miskovic, A. Simon, S. Dogan, U. Abdel-Rahman, and A. Moritz Seven years' experience with suture annuloplasty for mitral valve repair J. Thorac. Cardiovasc. Surg., January 1, 2006; 131(1): 99 - 106. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Feldman, H. S. Wasserman, H. C. Herrmann, W. Gray, P. C. Block, P. Whitlow, F. St. Goar, L. Rodriguez, F. Silvestry, A. Schwartz, et al. Percutaneous Mitral Valve Repair Using the Edge-to-Edge Technique: Six-Month Results of the EVEREST Phase I Clinical Trial J. Am. Coll. Cardiol., December 6, 2005; 46(11): 2134 - 2140. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Kouris, I. Ikonomidis, D. Kontogianni, P. Smith, and P. Nihoyannopoulos Mitral valve repair versus replacement for isolated non-ischemic mitral regurgitation in patients with preoperative left ventricular dysfunction. A long-term follow-up echocardiography study Eur J Echocardiogr, December 1, 2005; 6(6): 435 - 442. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J-L Monin Stress haemodynamics for asymptomatic mitral regurgitation: how much does it help? Heart, November 1, 2005; 91(11): 1383 - 1384. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R Lee, B Haluska, D Y Leung, C Case, J Mundy, and T H Marwick Functional and prognostic implications of left ventricular contractile reserve in patients with asymptomatic severe mitral regurgitation Heart, November 1, 2005; 91(11): 1407 - 1412. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. S. Shah, S. A. Hannish, C. A. Milano, and D. D. Glower Isolated Mitral Valve Repair in Patients With Depressed Left Ventricular Function Ann. Thorac. Surg., October 1, 2005; 80(4): 1309 - 1314. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Oc, G. Doukas, C. Alexiou, B. Oc, L. Hadjinikolaou, A. W. Sosnowski, and T. J. Spyt Edge-to-Edge Repair With Mitral Annuloplasty for Barlow's Disease Ann. Thorac. Surg., October 1, 2005; 80(4): 1315 - 1318. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Eguchi, E. Ohtaki, T. Matsumura, K. Tanaka, T. Tohbaru, N. Iguchi, K. Misu, R. Asano, M. Nagayama, T. Sumiyoshi, et al. Pre-operative atrial fibrillation as the key determinant of outcome of mitral valve repair for degenerative mitral regurgitation Eur. Heart J., September 2, 2005; 26(18): 1866 - 1872. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Matsukuma, K. Eishi, S. Yamachika, H. Yamaguchi, T. Ariyoshi, Y. Hisata, K. Tanigawa, K. Izumi, and H. Takai Risk Factors of Posterior Pericardial Annuloplasty for Isolated Posterior Leaflet Prolapse Ann. Thorac. Surg., September 1, 2005; 80(3): 820 - 824. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Aubert, T. Barreda, C. Acar, P. Leprince, N. Bonnet, R. Ecochard, A. Pavie, and I. Gandjbakhch Mitral valve repair for commissural prolapse: surgical techniques and long term results Eur. J. Cardiothorac. Surg., September 1, 2005; 28(3): 443 - 447. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Meurin, M. C. Iliou, A. B. Driss, B. Pierre, S. Corone, P. Cristofini, J. Y. Tabet, and on behalf of the Working Group of Cardiac Rehabili Early Exercise Training After Mitral Valve Repair: A Multicentric Prospective French Study Chest, September 1, 2005; 128(3): 1638 - 1644. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-L. Monin, P. Dehant, C. Roiron, M. Monchi, J.-Y. Tabet, P. Clerc, G. Fernandez, R. Houel, J. Garot, C. Chauvel, et al. Functional Assessment of Mitral Regurgitation by Transthoracic Echocardiography Using Standardized Imaging Planes: Diagnostic Accuracy and Outcome Implications J. Am. Coll. Cardiol., July 19, 2005; 46(2): 302 - 309. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Nagendran, C. Norris, A. Maitland, A. Koshal, and D. B. Ross Is mitral valve surgery safe in octogenarians? Eur. J. Cardiothorac. Surg., July 1, 2005; 28(1): 83 - 87. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Zegdi, M. Debieche, C. Latremouille, D. Lebied, C. Chardigny, J.-M. Grinda, S. Chauvaud, A. Deloche, A. Carpentier, and J.-N. Fabiani Long-Term Results of Mitral Valve Repair in Active Endocarditis Circulation, May 17, 2005; 111(19): 2532 - 2536. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Vassiliades Jr, P. C. Block, L. H. Cohn, D. H. Adams, J. S. Borer, T. Feldman, D. R. Holmes, W. K. Laskey, B. W. Lytle, M. J. Mack, et al. The Clinical Development of Percutaneous Heart Valve Technology: A Position Statement of the Society of Thoracic Surgeons (STS), the American Association for Thoracic Surgery (AATS), and the Society for Cardiovascular Angiography and Interventions (SCAI) Endorsed by the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) J. Am. Coll. Cardiol., May 3, 2005; 45(9): 1554 - 1560. [Full Text] [PDF]
|
|
|
|
|
|
P. C. Block Percutaneous Mitral Valve Repair: Are They Changing the Guard? Circulation, May 3, 2005; 111(17): 2154 - 2156. [Full Text] [PDF]
|
|
|
|
|
|
American College of Cardiology Foundation (ACCF) a, T. A. Vassiliades Jr, P. C. Block, L. H. Cohn, D. H. Adams, J. S. Borer, T. Feldman, D. R. Holmes, W. K. Laskey, B. W. Lytle, et al. The clinical development of percutaneous heart valve technology: A position statement of the Society of Thoracic Surgeons (STS), the American Association for Thoracic Surgery (AATS), and the Society for Cardiovascular Angiography and Interventions (SCAI) J. Thorac. Cardiovasc. Surg., May 1, 2005; 129(5): 970 - 976. [Full Text] [PDF]
|
|
|
|
|
|
T. A. Vassiliades Jr, P. C. Block, L. H. Cohn, D. H. Adams, J. S. Borer, T. Feldman, D. R. Holmes, W. K. Laskey, B. W. Lytle, M. J. Mack, et al. The Clinical Development of Percutaneous Heart Valve Technology: A Position Statement of The Society of Thoracic Surgeons (STS), the American Association for Thoracic Surgery (AATS), and the Society for Cardiovascular Angiography and Interventions (SCAI) Ann. Thorac. Surg., May 1, 2005; 79(5): 1812 - 1818. [Full Text] [PDF]
|
|
|
|
|
|
S. Talwar, M. R. Rajesh, A. Subramanian, A. Saxena, and A. S. Kumar Mitral valve repair in children with rheumatic heart disease J. Thorac. Cardiovasc. Surg., April 1, 2005; 129(4): 875 - 879. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Enriquez-Sarano, J.-F. Avierinos, D. Messika-Zeitoun, D. Detaint, M. Capps, V. Nkomo, C. Scott, H. V. Schaff, and A. J. Tajik Quantitative Determinants of the Outcome of Asymptomatic Mitral Regurgitation N. Engl. J. Med., March 3, 2005; 352(9): 875 - 883. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. H. Wu, K. D. Aaronson, S. F. Bolling, F. D. Pagani, K. Welch, and T. M. Koelling Impact of mitral valve annuloplasty on mortality risk in patients with mitral regurgitation and left ventricular systolic dysfunction J. Am. Coll. Cardiol., February 1, 2005; 45(3): 381 - 387. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.P. Kuhl and P. Hanrath The impact of transesophageal echocardiography on daily clinical practice Eur J Echocardiogr, December 1, 2004; 5(6): 455 - 468. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Hellgren, P. Kvidal, L.-G. Horte, U.-B. Krusemo, and E. Stahle Survival After Mitral Valve Replacement: Rationale for Surgery Before Occurrence of Severe Symptoms Ann. Thorac. Surg., October 1, 2004; 78(4): 1241 - 1247. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Langer, D. Aicher, A. Kissinger, O. Wendler, H. Lausberg, R. Fries, and H.-J. Schafers Aortic Valve Repair Using a Differentiated Surgical Strategy Circulation, September 14, 2004; 110(11_suppl_1): II-67 - II-73. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Timek, D. T. Lai, D. Liang, F. Tibayan, F. Langer, F. Rodriguez, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller Effects of Paracommissural Septal-Lateral Annular Cinching on Acute Ischemic Mitral Regurgitation Circulation, September 14, 2004; 110(11_suppl_1): II-79 - II-84. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Rodriguez, F. Langer, K. B. Harrington, F. A. Tibayan, M. K. Zasio, A. Cheng, D. Liang, G. T. Daughters, J. W. Covell, J. C. Criscione, et al. Importance of Mitral Valve Second-Order Chordae for Left Ventricular Geometry, Wall Thickening Mechanics, and Global Systolic Function Circulation, September 14, 2004; 110(11_suppl_1): II-115 - II-122. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. K. Haan, C. I. Cabral, D. A. Conetta, L. P. Coombs, and F. H. Edwards Selecting patients with mitral regurgitation and left ventricular dysfunction for isolated mitral valve surgery Ann. Thorac. Surg., September 1, 2004; 78(3): 820 - 825. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. H. Yacoub and L. H. Cohn Novel Approaches to Cardiac Valve Repair: From Structure to Function: Part II Circulation, March 9, 2004; 109(9): 1064 - 1072. [Full Text] [PDF]
|
|
|
|
|
|
O. Bech-Hanssen, T. Ryden, H. Schersten, A. Oden, F. Nilsson, and A. Jeppsson Mortality after mitral regurgitation surgery: importance of clinical and echocardiographic variables Eur. J. Cardiothorac. Surg., November 1, 2003; 24(5): 723 - 730. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. S. Dahlberg, T. A. Orszulak, C. J. Mullany, R. C. Daly, M. Enriquez-Sarano, and H. V. Schaff Late outcome of mitral valve surgery for patients with coronary artery disease Ann. Thorac. Surg., November 1, 2003; 76(5): 1539 - 1548. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. G. St. Goar, J. I. Fann, J. Komtebedde, E. Foster, M. C. Oz, T. J. Fogarty, T. Feldman, and P. C. Block Endovascular Edge-to-Edge Mitral Valve Repair: Short-Term Results in a Porcine Model Circulation, October 21, 2003; 108(16): 1990 - 1993. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. F. Ibrahim, D. Paparella, J. Ivanov, M. R. Buchanan, and S. J. Brister Gender-related differences in morbidity and mortality during combined valve and coronary surgery J. Thorac. Cardiovasc. Surg., October 1, 2003; 126(4): 959 - 964. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. R. Moss, K. H. Humphries, M. Gao, C. R. Thompson, J. G. Abel, G. Fradet, and B. I. Munt Outcome of Mitral Valve Repair or Replacement: A Comparison by Propensity Score Analysis Circulation, September 9, 2003; 108(90101): II-90 - 97. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Feindel, Z. Tufail, T. E. David, J. Ivanov, and S. Armstrong Mitral valve surgery in patients with extensive calcification of the mitral annulus J. Thorac. Cardiovasc. Surg., September 1, 2003; 126(3): 777 - 781. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Matsumura, E. Ohtaki, K. Tanaka, K. Misu, T. Tobaru, R. Asano, M. Nagayama, K. Kitahara, J. Umemura, T. Sumiyoshi, et al. Echocardiographic prediction ofleft ventricular dysfunction aftermitral valve repair for mitral regurgitation as anindicator to decide the optimal timing of repair J. Am. Coll. Cardiol., August 6, 2003; 42(3): 458 - 463. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. H. Thourani, W. S. Weintraub, R. A. Guyton, E. L. Jones, W. H. Williams, S. Elkabbani, and J. M. Craver Outcomes and Long-Term Survival for Patients Undergoing Mitral Valve Repair Versus Replacement: Effect of Age and Concomitant Coronary Artery Bypass Grafting Circulation, July 22, 2003; 108(3): 298 - 304. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Reimold and J. D. Rutherford Valvular Heart Disease in Pregnancy N. Engl. J. Med., July 3, 2003; 349(1): 52 - 59. [Full Text] [PDF]
|
|
|
|
|
|
A. M. Gillinov, C. Faber, P. L. Houghtaling, E. H. Blackstone, B.-K. Lam, R. Diaz, B. W. Lytle, J. F. Sabik III, and D. M. Cosgrove III Repair versus replacement for degenerative mitral valve disease with coexisting ischemic heart disease J. Thorac. Cardiovasc. Surg., June 1, 2003; 125(6): 1350 - 1362. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Gillinov, E. H. Blackstone, D. M. Cosgrove III, J. White, P. Kerr, A. Marullo, P. M. McCarthy, and B. W. Lytle Mitral valve repair with aortic valve replacement is superior to double valve replacement J. Thorac. Cardiovasc. Surg., June 1, 2003; 125(6): 1372 - 1387. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Bevilacqua, A. G. Cerillo, J. Gianetti, U. Paradossi, M. Mariani, S. Matteucci, E. Kallushi, and M. Glauber Mitral valve repair for degenerative disease: is pericardial posterior annuloplasty a durable option? Eur. J. Cardiothorac. Surg., April 1, 2003; 23(4): 552 - 559. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Flameng, P. Herijgers, and K. Bogaerts Recurrence of Mitral Valve Regurgitation After Mitral Valve Repair in Degenerative Valve Disease Circulation, April 1, 2003; 107(12): 1609 - 1613. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. B. Savage, T. B. Ferguson Jr, and V. J. DiSesa Use of mitral valve repair: analysis of contemporary United States experience reported to the Society of Thoracic Surgeons National Cardiac Database Ann. Thorac. Surg., March 1, 2003; 75(3): 820 - 825. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M Otto Timing of surgery in mitral regurgitation Heart, January 1, 2003; 89(1): 100 - 105. [Full Text] [PDF]
|
|
|
|
|
|
R. C. Gorman, J. H. Gorman III, and L. H. Edmunds Jr. Ischemic Mitral Regurgitation Card. Surg. Adult, January 1, 2003; 2(2003): 751 - 769. [Full Text]
|
|
|
|
|
|
H. V. Schaff and D. H. Marsh Multiple Valve Disease Card. Surg. Adult, January 1, 2003; 2(2003): 1017 - 1045. [Full Text]
|
|
|
|
 |
|
 S. H. Rahimtoola Drug-Related Valvular Heart Disease: Here We Go Again: Will We Do Better This Time? Mayo Clin. Proc., December 1, 2002; 77(12): 1275 - 1277. [PDF]
|
|
|
|
|
|
H. P. Chaliki, D. Mohty, J.-F. Avierinos, C. G. Scott, H. V. Schaff, A. J. Tajik, and M. Enriquez-Sarano Outcomes After Aortic Valve Replacement in Patients With Severe Aortic Regurgitation and Markedly Reduced Left Ventricular Function Circulation, November 19, 2002; 106(21): 2687 - 2693. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D Pellerin, S Brecker, and C Veyrat Degenerative mitral valve disease with emphasis on mitral valve prolapse Heart, November 1, 2002; 88(90004): iv20 - 28. [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||