Functional Mitral Stenosis After Restrictive Annuloplasty

Findings from a small case-cohort study reveal a potentially important drawback of a standard treatment for mitral regurgitation.

Restrictive annuloplasty using an undersized ring is sometimes performed with coronary artery bypass grafting to treat ischemic mitral regurgitation (MR). In this study, 24 patients underwent dobutamine stress echocardiography about 1 year after restrictive annuloplasty and CABG, and 22 of them completed a 6-minute walk test. Their results were compared with measures in a control group of 20 patients with coronary artery disease, matched for age, gender and LV ejection fraction.

Despite improvements in postoperative LV geometry and ejection fraction, the annuloplasty patients’ resting peak and mean transmitral gradients were 13 mmHg and 6 mmHg, respectively, and their systolic pulmonary artery pressure was 42 mmHg, all significantly higher t…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI