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European Heart Journal Advance Access published online on December 12, 2007
European Heart Journal, doi:10.1093/eurheartj/ehm531
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©Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Surgical correction of ischaemic mitral regurgitation—still a long way to go

Philippe Kolh*

Service de Cardiochirurgie, CHU Sart Tilman, B 35 Sart Tilman, Liège 4000, Belgium

* Corresponding author. Tel: +32 4 366 7163, Fax: +32 4 221 31 58, Email: philippe.kolh@chu.ulg.ac.be

This editorial refers to ‘Five-year echocardiographic results of combined undersized mitral ring annuloplasty and coronary artery bypass grafting for chronic ischaemic mitral regurgitation’ by S. Gelsomino et al., doi:10.1093/eurheartj/ehm468

The first 10% of the full text of this article appears below.

Elegant experimental work has helped in understanding the pathogenesis of chronic ischaemic mitral regurgitation (IMR), which appears to be the consequence of a combination of two distinct anatomical abnormalities.1 Globally, annular dilatation occurs secondary to left ventricular (LV) enlargment, causing incomplete coaptation of the mitral valve despite normal leaflet motion. Locally, inferior wall remodelling produces papillary muscle displacement with restricted motion of the mitral leaflets.

Chronic IMR, an independent predictor of mortality with a reported survival of 40–60% at 5 years,2–5 is a progressive disorder in which MR-related LV volume overload promotes further LV remodelling, leading to worsened MR. Therefore, surgical correction, either by replacement or repair, is recommended for 3+ and 4+ IMR.6 Furthermore, repair, as compared with replacement, appears to benefit most patients with IMR, with the possible exceptions of very high hisk group, such as patients in New . . . [Full Text of this Article]


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Related articles in EHJ:

Five-year echocardiographic results of combined undersized mitral ring annuloplasty and coronary artery bypass grafting for chronic ischaemic mitral regurgitation
Sandro Gelsomino, Roberto Lorusso, Giuseppe De Cicco, Irene Capecchi, Carlo Rostagno, Sabina Caciolli, Stefano Romagnoli, Ugo Da Broi, Pierluigi Stefàno, and Gian Franco Gensini
EHJ 2008 29: 231-240. [Abstract] [FREE Full Text]  



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G. D'Ancona, D. Biondo, G. Mamone, G. Marrone, F. Pirone, G. Santise, S. Sciacca, and M. Pilato
Ischemic mitral valve regurgitation in patients with depressed ventricular function: cardiac geometrical and myocardial perfusion evaluation with magnetic resonance imaging
Eur. J. Cardiothorac. Surg., November 1, 2008; 34(5): 964 - 968.
[Abstract] [Full Text] [PDF]