Abstract 13134: Comprehensive Echocardiographic Assessment of Mitral Valve Hemodynamic Parameters Early After Surgical Mitral Valve Repair
Background: Normal Doppler-derived hemodynamic data for mitral valves after surgical mitral valve repair is lacking.
Methods: From a group of 568 patients who underwent mitral valve replacement for mitral regurgitation at Mayo Clinic between 1993–2008, we selected 397 patients in whom an early post-operative comprehensive echocardiogram was performed. From a group of 4131 patients undergoing surgical mitral valve repair during the same period, we selected 397 age and gender matched patients in whom an early complete echocardiographic evaluation was performed. All of these repairs included annuloplasty band placement.
Results: In this study cohort, there was no significant difference between the number of patients undergoing mitral valve repair vs mitral valve replacement for organic (99 vs 113, p=0.26) or non-ischemic functional regurgitation (47 vs 39, p=0.36). Significantly more patients with ischemic mitral regurgitation underwent mitral valve replacement vs mitral valve repair (74 vs 52, p=0.03). Patients undergoing mitral valve repair had significantly better hemodynamic performance compared with patients undergoing mitral valve replacement with either a tissue or mechanical prosthesis. The LVEF and stroke volume index were significantly higher for the repair patients. In addition, patients undergoing mitral valve repair had significantly larger mitral EOA and indexed EOA. Despite having larger stroke volumes, repair patients had significantly lower mean gradient, mitral E velocity, TVIMVP, TVIMVI/TVILVOT, and calculated pulmonary artery systolic pressure compared to patients undergoing mitral valve replacement.
Conclusions: The Doppler-derived hemodynamic parameters of patients undergoing successful surgical mitral valve repair are excellent and are significantly better than the parameters of patients undergoing mitral valve replacement with either tissue or mechanical prostheses for treatment of mitral valve regurgitation.
- © 2010 by American Heart Association, Inc.