Letter by Pocar Regarding Article, “Impact of Left Ventricular to Mitral Valve Ring Mismatch on Recurrent Ischemic Mitral Regurgitation After Ring Annuloplasty”
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To the Editor:
Capoulade et al1 should be commended for outlining the interesting correlation between left ventricular end-systolic dimension to mitral valve ring size ratio (LVESd/MV) and recurrent ischemic mitral regurgitation (MR) after annuloplasty. The authors, however, do not suggest a preoperative LVESd/MV cutoff to predict an unsuccessful repair. Considering the observed 30% MR recurrence, it could be assumed that the 4th quartile may represent patients more likely to have an unsuccessful repair. This implies that an LVESd/MV >2 could possibly indicate the limit for not performing annuloplasty alone. However, MR recurrence ≥2+ rates as low as 15% at 4.3 years have …