ECHOCARDIOGRAPHIC AND CARDIAC SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY PREDICTORS OF LEFT VENTRICLE REVERSE REMODELING AFTER SURGICAL REVASCULARIZATION IN PATIENTS WITH ISCHEMIC CARDIOMYOPATHY AND LEFT VENTRICLE SYSTOLIC DYSFUNCTION

Predictors of failure following restrictive annuloplasty for chronic ischemic mitral regurgitation

AIM OF THE STUDY

We sought to determine the results of restrictive annuloplasty for chronic ischemic mitral regurgitation.

METHODS

Hospital outcome and serial clinical and echocardiographic (preoperative, discharge, 3 months, 12 months, 24 months) follow-up assessments were analyzed in 87 consecutive patients with chronic ischemic mitral regurgitation having coronary artery bypass grafting. Persistent/recurrent mitral regurgitation was defined by grade ≥2 at discharge/during follow-up.

RESULTS

Hospital mortality was 5.7% and persistence of regurgitation was present in 8.4%. Mean follow-up was 24.4 ± 1.7 months and recurrent mitral regurgitation was observed in 32.4% patients. In multivariate analysis only anterior leaflet angle remained an independent predictive factor for regurgitation recurrence with cutoff 27° (sensitivity of 67% and specificity of 76%, p = 0.04).

CONCLUSION

There is high occurrence of early and delayed restrictive annuloplasty failure, particularly in patients with increased anterior leaflet tethering.