The Journal of Thoracic and Cardiovascular Surgery
Volume 128, Issue 4 , Pages 543-551 , October 2004

Functional mitral regurgitation in chronic ischemic coronary artery disease: Analysis of geometric alterations of mitral apparatus with magnetic resonance imaging

  • Hsi-Yu Yu, MD

      Affiliations

    • Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan, ROC
    • Institute of Biomedical Engineering, National Taiwan University Medical College, Taipei, Taiwan, ROC
    • ,
  • Mao-Yuan Su, MS

      Affiliations

    • Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan, ROC
    • ,
  • Ta-Yu Liao, MS

      Affiliations

    • Institute of Biomedical Engineering, National Taiwan University Medical College, Taipei, Taiwan, ROC
    • ,
  • Hsu-Hsia Peng, MD

      Affiliations

    • Center for Optoelectronic Biomedicine, National Taiwan University Medical College, Taipei, Taiwan, Republic of China
    • ,
  • Fang-Yue Lin, MD, PhD

      Affiliations

    • Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan, ROC
    • ,
  • Wen-Yih Isaac Tseng, MD, PhD

      Affiliations

    • Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan, ROC
    • Center for Optoelectronic Biomedicine, National Taiwan University Medical College, Taipei, Taiwan, Republic of China
    • Corresponding Author InformationAddress for reprints: Wen-Yih Isaac Tseng, MD, PhD, No. 1, Jen-Ai Road, Sec. 1, Center for Optoelectronic Biomedicine, National Taiwan University Medical College, Taipei, Taiwan, ROC

Received 13 December 2003 ,Revised 31 March 2004 ,Accepted 6 April 2004.

References 

  1. Robbins JD, Maniar PB, Cotts W, Parker MA, Bonow RO, Gheorghiade M. Prevalence and severity of mitral regurgitation in chronic systolic heart failure. Am J Cardiol. 2003;91(3):360–362
  2. Tseng WY, Liao TY, Wang JL. Normal systolic and diastolic functions of the left ventricle and left atrium by cine magnetic resonance imaging. J Cardiovasc Magn Reson. 2002;4(4):443–457
  3. Tahta SA, Oury JH, Maxwell JM, Hiro SP, Duran CMG. Outcome after mitral valve repair for functional ischemic mitral regurgitation. J Heart Valve Dis. 2002;11(1):11–18
  4. Shah PM, Raney AA. Echocardiographic correlates of left ventricular outflow obstruction and systolic anterior motion following mitral valve repair. J Heart Valve Dis. 2001;10(3):302–306
  5. Gorman RC, Mccaughan JS, Ratcliffe MB, Gupta KB, Streicher JT, Ferrari VA, et al.  Pathogenesis of acute ischemic mitral regurgitation in 3 dimensions. J Thorac Cardiovasc Surg. 1995;109(4):684–693
  6. Timek TA, Lai DT, Liang DH, Lo ST, Daughters GT, Ingels NB, et al.  Timing and location of acute ischemic mitral regurgitation in sheep. Circulation. 2000;102(18):530–531
  7. Timek TA, Lai DT, Tibayan F, Liang D, Daughters GT, Dagum P, et al.  Septal-lateral annular cinching abolishes acute ischemic mitral regurgitation. J Thorac Cardiovasc Surg. 2002;123(5):881–888
  8. Timek TA, Lai DT, Tibayan F, Liang D, Rodriguez F, Daughters GT, et al.  Annular versus subvalvular approaches to acute ischemic mitral regurgitation. Circulation. 2002;106(suppl I):I27–32
  9. Tibayan FA, Rodriguez F, Zasio MK, Bailey L, Liang D, Daughters GT, et al.  Geometric distortions of the mitral valvular-ventricular complex in chronic ischemic mitral regurgitation. Circulation. 2003;108(suppl II):116–121
  10. Enriquez-Sarano R, Freeman WK, Tribouilloy CM, Orszulak TA, Khandheria BK, Seward JB, et al.  Functional anatomy of mitral regurgitation—accuracy and outcome implications of transesophageal echocardiography. J Am Coll Cardiol. 1999;34(4):1129–1136
  11. Otsuji Y, Handschumacher MD, Schwammenthal E, Jiang L, Song JK, Guerrero L, et al.  Insights from three-dimensional echocardiography into the mechanism of functional mitral regurgitation—direct in vivo demonstration of altered leaflet tethering geometry. Circulation. 1997;96(6):1999–2008
  12. Kaplan SR, Bashein G, Sheehan FH, Legget ME, Munt B, Li XN, et al.  Three-dimensional echocardiographic assessment of annular shape changes in the normal and regurgitant mitral valve. Am Heart J. 2000;139(3):378–387
  13. Otsuji Y, Handschumacher MD, Liel-Cohen N, Tanabe H, Jiang L, Schwammenthal E, et al.  Mechanism of ischemic mitral regurgitation with segmental left ventricular dysfunction (three-dimensional echocardiographic studies in models of acute and chronic progressive regurgitation). J Am Coll Cardiol. 2001;37(2):641–648
  14. Poutanen T, Jokinen E, Sairanen H, Tikanoja T. Left atrial and left ventricular function in healthy children and young adults assessed by three dimensional echocardiography. Heart. 2003;89(5):544–549
  15. Sabbah HN, Kono T, Rosman H, Jafri S, Stein PD, Goldstein S. Left-ventricular shape—a factor in the etiology of functional mitral regurgitation in heart-failure. Am Heart J. 1992;123(4):961–966
  16. Nass O, Rosman H, Alkhaled N, Shimoyama H, Alam M, Sabbah HN, et al.  Relation of left-ventricular chamber shape in patients with low (less-than-or-equal-to-40-percent) ejection fraction to severity of functional mitral regurgitation. Am J Cardiol. 1995;76(5):402–404
  17. He SQ, Lemmon JD, Weston MW, Jensen MOJ, Levine RA, Yoganathan AP. Mitral valve compensation for annular dilatation (in vitro study into the mechanisms of functional mitral regurgitation with an adjustable annulus model). J Heart Valve Dis. 1999;8(3):294–302
  18. Gorman JH, Gorman RC, Jackson BM, Hiramatsu Y, Gikakis NS, Kelley ST, et al.  Anterior and posterior papillary muscle discoordination, not annular dilatation, causes acute mitral regurgitation after posterior infarction. Circulation. 1996;94(8):3125
  19. Cohn JN. Structural basis for heart failure. Ventricular remodeling and its pharmacological inhibition. Circulation. 1995;91(10):2504–2507
  20. Lai DT, Timek TA, Tibayan FA, Green GR, Daughters GT, Liang D, et al.  The effects of mitral annuloplasty rings on mitral valve complex 3-D geometry during acute left ventricular ischemia. Eur J Cardiothorac Surg. 2002;22(5):808–816
  21. Komeda M, Glasson JR, Bolger AF, Daughters GT, MacIsaac A, Oesterle SN, et al.  Geometric determinants of ischemic mitral regurgitation. Circulation. 1997;96(9):128–133
  22. Liel-Cohen N, Guerrero JL, Otsuji Y, Handschumacher MD, Rudski LG, Hunziker PR, et al.  Design of a new surgical approach for ventricular remodeling to relieve ischemic mitral regurgitation (insights from 3-dimensional echocardiography). Circulation. 2000;101(23):2756–2763
  23. Tibayan FA, Rodriguez F, Liang D, Daughters GT, Ingels NB, Miller DC. Paneth suture annuloplasty abolishes acute ischemic mitral regurgitation but preserves annular and leaflet dynamics. Circulation. 2003;108(10):128–133
  24. Messas E, Pouzet B, Touchot B, Guerrero JL, Vlahakes GJ, Desnos M, et al.  Efficacy of chordal cutting to relieve chronic persistent ischemic mitral regurgitation. Circulation. 2003;108(10):111–115
  25. Sabbah HN. The cardiac support device and the myosplint (treating heart failure by targeting left ventricular size and shape). Ann Thorac Surg. 2003;75(suppl):S13–19
  26. Menicanti L, Di Donato M, Frigiola A, Buckberg G, Santambrogio C, Ranucci M, et al.  Ischemic mitral regurgitation (intraventricular papillary muscle imbrication without mitral ring during left ventricular restoration). J Thorac Cardiovasc Surg. 2002;123(6):1041–1050
  27. Hvass U, Tapia M, Baron F, Pouzet B, Shafy A. Papillary muscle sling (a new functional approach to mitral repair in patients with ischemic left ventricular dysfunction and functional mitral regurgitation). Ann Thorac Surg. 2003;75(3):809–811
  28. von Oppell UO, Stemmet F, Brink J, Commerford PJ, Heijke SA. Ischemic mitral valve repair surgery. J Heart Valve Dis. 2000;9(1):64–73

☆ This work was supported by the National Science Council, Taiwan (NSC91-2314-B-002-217-M08 and NSC93WFA0100159).

PII: S0022-5223(04)00640-3

doi: 10.1016/j.jtcvs.2004.04.015

The Journal of Thoracic and Cardiovascular Surgery
Volume 128, Issue 4 , Pages 543-551 , October 2004

Article Tools

* Image Usage & Resolution