What is the clinical evidence from this study?

Study design: Observational. Population: Chronic ischemic mitral regurgitation and advanced ischemic cardiomyopathy (n=100). Intervention: Restrictive mitral valve annuloplasty with the Carpentier-Edwards Physio ring and CABG. Primary outcome: Residual mitral regurgitation grade at 2.5 years (p=<0.0005).

August 1, 2008The Heart Surgery ForumOpen Access

Restrictive Mitral Valve Annuloplasty for Chronic Ischemic Mitral Regurgitation: A 5-Year Clinical Experience with the Physio Ring

Q: What are the key findings of this study?

Restrictive mitral valve annuloplasty using the Physio ring significantly reduced chronic ischemic mitral regurgitation from a mean baseline grade of 3.6 to 0.4 at 2.5 years.

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Key result

Restrictive mitral valve annuloplasty using the Physio ring significantly reduced chronic ischemic mitral regurgitation from a mean baseline grade of 3.6 to 0.4 at 2.5 years.

Why the study?

Does restrictive mitral valve annuloplasty with a semirigid ring and concomitant CABG improve clinical and echocardiographic outcomes in patients with chronic ischemic mitral regurgitation and advanced ischemic cardiomyopathy?

Population

100 consecutive patients with moderately severe to severe chronic ischemic mitral regurgitation and advanced…

Design

Cohort

Follow-up

2.5 +/- 1.0 years

Authors

SGStephan GeidelAsklepios Klinik St. Georg MLMichael LaßPaderborn University JOJ. OstermeyerAsklepios Klinik St. Georg

Discussion

Member takes

Overview

Associated with durable MR reduction in ischemic cardiomyopathy; leaves open whether it improves survival versus alternatives in RCTs.

Study Design

Type

Observational (n=100)

Multicenter

Structured PICO

Population

100 patients (mean age 69 years, 34% female) with moderately severe to severe chronic ischemic mitral regurgitation and advanced ischemic cardiomyopathy undergoing restrictive mitral annuloplasty and CABG, followed for a mean of 2.5 years.

Intervention

Standardized restrictive prosthetic ring annuloplasty (downsizing of 2.7 +/- 1.0 ring sizes) using the semirigid Carpentier-Edwards Physio ring and concomitant coronary artery bypass grafting.

Outcome

Survival, residual MR, NYHA class, and LV function (end-systolic and end-diastolic dimension/volume indices and LVEF) at 8 +/- 1 days, 3 +/- 1 months, and 2.5 +/- 1.0 years after surgery.surrogate

Main Result

Absolute Event Rate: 0.4% vs 3.6%

p-value: p=<0.0005

Restrictive mitral valve annuloplasty with a semirigid ring and concomitant CABG effectively corrects chronic ischemic mitral regurgitation and promotes reverse left ventricular remodeling with low mortality.

Limitations

Echocardiographic indices for evaluating global myocardial remodeling described by other investigators were not evaluated.
The study was not designed for patients with ischemic cardiomyopathy and chronic mitral regurgitation of less than grade 3.
The study population remained inhomogeneous, with 40 concomitant surgical procedures performed in 30 patients.
The long-term prognosis of the patients is still unknown.

Cite This Study

Geidel et al. (2008) conducted an observational in Chronic ischemic mitral regurgitation and advanced ischemic cardiomyopathy (n=100). Restrictive mitral valve annuloplasty with the Carpentier-Edwards Physio ring and CABG was evaluated on Residual mitral regurgitation grade at 2.5 years (p=<0.0005). Restrictive mitral valve annuloplasty using the Physio ring significantly reduced chronic ischemic mitral regurgitation from a mean baseline grade of 3.6 to 0.4 at 2.5 years.

synapsesocial.com/papers/6a95ba0c3ea7ffc69dbaeb28 https://doi.org/10.1532/hsf98.20081028

Topics

Mitral valve intervention Echocardiography Women and heart disease

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August 1, 2008The Heart Surgery ForumOpen Access

Restrictive Mitral Valve Annuloplasty for Chronic Ischemic Mitral Regurgitation: A 5-Year Clinical Experience with the Physio Ring

View Full Paper

Ask AI

Bookmark

Key result

Restrictive mitral valve annuloplasty using the Physio ring significantly reduced chronic ischemic mitral regurgitation from a mean baseline grade of 3.6 to 0.4 at 2.5 years.

Why the study?

Population

100 consecutive patients with moderately severe to severe chronic ischemic mitral regurgitation and advanced…

Design

Cohort

Follow-up

2.5 +/- 1.0 years

Authors

SGStephan GeidelAsklepios Klinik St. Georg MLMichael LaßPaderborn University JOJ. OstermeyerAsklepios Klinik St. Georg

Discussion

Member takes

Overview

Associated with durable MR reduction in ischemic cardiomyopathy; leaves open whether it improves survival versus alternatives in RCTs.

Study Design

Type

Observational (n=100)

Multicenter

Structured PICO

Population

Intervention

Standardized restrictive prosthetic ring annuloplasty (downsizing of 2.7 +/- 1.0 ring sizes) using the semirigid Carpentier-Edwards Physio ring and concomitant coronary artery bypass grafting.

Outcome

Survival, residual MR, NYHA class, and LV function (end-systolic and end-diastolic dimension/volume indices and LVEF) at 8 +/- 1 days, 3 +/- 1 months, and 2.5 +/- 1.0 years after surgery.surrogate

Main Result

Absolute Event Rate: 0.4% vs 3.6%

p-value: p=<0.0005

Limitations

Echocardiographic indices for evaluating global myocardial remodeling described by other investigators were not evaluated.
The study was not designed for patients with ischemic cardiomyopathy and chronic mitral regurgitation of less than grade 3.
The study population remained inhomogeneous, with 40 concomitant surgical procedures performed in 30 patients.
The long-term prognosis of the patients is still unknown.

Cite This Study

synapsesocial.com/papers/6a95ba0c3ea7ffc69dbaeb28 https://doi.org/10.1532/hsf98.20081028

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Topics

Mitral valve intervention Echocardiography Women and heart disease

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