September 18, 2001Circulation
Anterior Chordal Transection Impairs Not Only Regional Left Ventricular Function But Also Regional Right Ventricular Function in Mitral Regurgitation
Key result
Mitral valve replacement with anterior chordal transection impaired regional left ventricular function (LVEF region 4: 77.6% vs 87.7%, P=0.005) and right ventricular function compared to repair.
Why the study?
Does mitral valve replacement with anterior chordal transection impair regional LV and RV function compared to mitral valve repair in patients with severe mitral regurgitation?
Population
65 patients with severe mitral regurgitation (MR)
Comparison
Mitral valve replacement with anterior chordal… vs Mitral valve repair
Design
Cohort
Authors
Discussion
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Member takes
Implication
Suggests caution with anterior chordal transection during replacement; leaves open whether repair should be prioritized in severe MR.
Study Design
Type
Cohort (n=65)
Structured PICO
Does mitral valve replacement with anterior chordal transection impair regional LV and RV function compared to mitral valve repair in patients with severe mitral regurgitation?
P
Population
65 patients with severe mitral regurgitation undergoing mitral valve repair or replacement with anterior chordal transection.
E
Exposure
Mitral valve replacement with anterior chordal transection
C
Comparator
Mitral valve repair
O
Outcome
Global and regional left ventricular (LV) and right ventricular (RV) ejection fractions (EF) determined by radionuclide angiography at restsurrogate
Main Result
Absolute Event Rate: 77.6% vs 87.7%
p-value: p=0.005
Anterior chordal transection during mitral valve replacement impairs both regional left and right ventricular function compared to mitral valve repair.
Cite This Study
Tourneau et al. (2001) conducted a cohort in Severe mitral regurgitation (n=65). Mitral valve replacement with anterior chordal transection vs. Mitral valve repair was evaluated on Regional LVEF in the area of anterior papillary muscle insertion (region 4) (p=0.005). Mitral valve replacement with anterior chordal transection impaired regional left ventricular function (LVEF region 4: 77.6% vs 87.7%, P=0.005) and right ventricular function compared to repair.