Key result
Narrow postoperative aortomitral angle predicts cardiovascular events after mitral valve repair for aFMR.
Why the study?
The geometric parameters of the aortomitral complex affecting postoperative cardiovascular events in patients with atrial functional mitral regurgitation remained to be elucidated.
Does the postoperative aortomitral angle predict cardiovascular events in patients undergoing mitral valve repair for atrial functional mitral regurgitation?
Cohort (n=58)
Does the postoperative aortomitral angle predict cardiovascular events in patients undergoing mitral valve repair for atrial functional mitral regurgitation?
A narrow postoperative aortomitral angle independently predicts cardiovascular events after mitral valve repair for atrial functional MR, and left atrial plication may help maintain an obtuse angle.
May inform risk stratification after mitral valve repair; leaves open whether angle optimization improves outcomes.
PURPOSE: This study aimed to elucidate the geometric parameters of the aortomitral (AM) complex affecting postoperative cardiovascular events (CVEs) in patients with atrial functional mitral regurgitation (MR). METHODS: From October 2008 to August 2018, we performed mitral and tricuspid valve repairs in 58 patients with atrial functional MR. We examined the determinants of CVEs using preoperative and postoperative echocardiographic data. Furthermore, we analyzed the effect of left atrial (LA) plication on AM geometries after surgery. The follow-up period ranged from 56 to 3283 days (median, 1073 days). RESULTS: All patients underwent mitral and tricuspid annuloplasty. Seventeen patients (29%) underwent additional LA plication. The AM angle was narrowed after surgery in patients with CVEs (115° ± 6.8° to 106° ± 4.2°, p = .00336), whereas it widened in patients without CVEs (115° ± 7.4° to 118° ± 8.4°, p = .0278). The postoperative AM angle was an independent predictor of postoperative CVEs (p = .000829). LA plication was not a predictor of CVEs; however, it was a predictor of the obtuse postoperative AM angle (p = .0071). CONCLUSIONS: Our results suggest that a narrow postoperative AM angle is an independent predictor of postoperative CVEs. Additional LA plication reduces the sharpening of the AM angle, which may prevent CVEs after mitral valve repair for atrial functional MR.
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Takahashi et al. (2022) conducted a cohort in Atrial functional mitral regurgitation (n=58). Narrow postoperative aortomitral (AM) angle vs. Wider postoperative AM angle was evaluated on Postoperative cardiovascular events (CVEs) (p=.000829). A narrow postoperative aortomitral angle was an independent predictor of postoperative cardiovascular events (p = .000829) after mitral valve repair for atrial functional mitral regurgitation.
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