August 30, 2005Circulation
Mitral Valve Repair for Functional Mitral Regurgitation in End-Stage Dilated Cardiomyopathy
Why the study?
Does the addition of the edge-to-edge technique to undersized annuloplasty improve the durability of mitral valve repair in patients with end-stage dilated cardiomyopathy and functional mitral regurgitation?
Population
77 patients with end-stage idiopathic or ischemic dilated cardiomyopathy and functional mitral…
Comparison
Mitral valve repair using edge-to-edge technique… vs Isolated undersized annuloplasty.
Design
Cohort
Follow-up
mean 18.4+/-9.8 months
Authors
Discussion
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Member takes
Implication
May support edge-to-edge addition for durable repair in functional MR; hypothesis-generating, needs randomized confirmation.
Structured PICO
Does the addition of the edge-to-edge technique to undersized annuloplasty improve the durability of mitral valve repair in patients with end-stage dilated cardiomyopathy and functional mitral regurgitation?
P
Population
77 patients with end-stage idiopathic (n=26) or ischemic (n=51) dilated cardiomyopathy (DCM) and functional mitral regurgitation (grade 3 to 4+/4+). 75.3% NYHA class III, 24.6% NYHA class IV.
I
Intervention
Mitral valve repair using edge-to-edge technique combined with annuloplasty (n=54, for coaptation depth >=1 cm).
C
Comparator
Isolated undersized annuloplasty (n=23, for coaptation depth <1 cm).
O
Outcome
Mitral repair failure (recurrence of MR >=3+/4+), hospital mortality, actuarial survival, freedom from cardiac events, and NYHA class improvement.hard clinical
In patients with end-stage dilated cardiomyopathy, mitral valve repair is feasible, and adding the edge-to-edge technique to undersized annuloplasty significantly improves repair durability.
Cite This Study
Bonis et al. (2005) studied this question.