Changes of left ventricular structure and function after minimally invasive repair of mitral valve prolapse_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YAO Liping ^1,2 ,  DONG Liya ¹ , ZHANG Li ¹ , XU Zhen ¹ , MEI Ju ¹ , DING Fangbao ¹

1. Department of Cardiothoracic Surgery, Congming Brach of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, P.R.China;
2. Department of Cardiothoracic Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, P.R.China;

Corresponding?author：

DONG Liya, Email: dongliya@xinhuamed.com.cn

Keywords：

Minimally invasive repair; mitral valve prolapse; echocardiography; left ventricular diastolic function

DOI：

10.7507/1007-4848.201901010

Video：

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Objective To evaluate the changes of left ventricular structure and function by echocardiography and its grading of left ventricular diastolic function in patients with mitral valve prolapse treated by minimally invasive mitral valve repair.Methods By retrospective analysis, 37 patients including 25 males and 12 females aged 53.49±11.02 years with mitral valve prolapse who underwent minimally invasive mitral valve repair were as an operation group, and 34 healthy persons including 19 males and 15 females aged 54.26±8.33 years matched by age and sex were selected as a control group. Ultrasound parameters of every participant were routinely collected before operation, 1 month, 3 months, 6 months and 1 year after operation, and left ventricular diastolic function was graded. The ultrasound parameters between the two groups were compared.Results The diameters of left ventricular end systolic and diastolic phase, left atrial diameter and left ventricular volume in the operation group were significantly smaller than those before operation. The diameters of left ventricle and left atrium after operation were significantly shorter than those before operation, but they were still larger than those of the control group. The ejection fraction value decreased significantly at one month after the operation and then returned to normal level. The incidence of left ventricular diastolic dysfunction at 6 months and 1 year after operation was significantly lower than that before operation (P<0.05).Conclusion Minimally invasive repair for patients with mitral valve prolapse can significantly improve systolic and diastolic functions of left ventricle while reconstructing left atrial and left ventricular structures.

Citation： YAO Liping, DONG Liya, ZHANG Li, XU Zhen, MEI Ju, DING Fangbao. Changes of left ventricular structure and function after minimally invasive repair of mitral valve prolapse. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(10): 958-962. doi: 10.7507/1007-4848.201901010 Copy

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2.	Zoghbi WA, Enriquez-Sarano M, Foster E, et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr, 2003, 16(7): 777-802.
3.	Bonow RO, Carabello BA, Kanu C, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation, 2006, 114(5): e84-e231.
4.	Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging, 2016, 17(12): 1321-1360.
5.	姜兆磊, 梅舉, 湯敏, 等. 改良人工腱索技術在右胸微創切口二尖瓣成形術中的應用及效果評價. 中國心血管病研究雜志, 2017, 15(5): 406-409.
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7.	喬瑞國, 黃信生, 汪川, 等. 二尖瓣后葉三角形切除成形術的療效分析. 中華胸心血管外科雜志, 2017, 33(10): 580-582.
8.	鮑春榮, 梅舉, 丁芳寶, 等. "緣對緣"技術防治二尖瓣成形術后收縮期前向運動及中遠期隨訪結果. 中國心血管病研究雜志, 2017, 15(7): 640-644.
9.	鄧學峰, 高長青. 二尖瓣成形術治療二尖瓣關閉不全. 中國胸心血管外科臨床雜志, 2008, 15(2): 134-137.
10.	郭穎, 王水云, 段雪晶, 等. 二尖瓣脫垂患者的臨床特點及預后分析. 中華心血管病雜志, 2017, 45(10): 848-851.
11.	孫海寧, 王巍, 宋云虎, 等. 二尖瓣成形術治療二尖瓣前葉脫垂的療效分析. 中國胸心血管外科臨床雜志, 2010, 17(4): 283-286.
12.	李紅巖, 韓勁松, 王輝山, 等. 退行性二尖瓣關閉不全行二尖瓣成形術305例臨床分析. 中國心血管病研究雜志, 2016, 14(10): 922-926.
13.	陳宏偉, 鄭理玲, 謝納新, 等. 二尖瓣成形術治療二尖瓣后葉脫垂. 中國心血管病研究雜志, 2012, 10(5): 329-332.
14.	張衛, 郭震, 葉偉. 二尖瓣成形術的臨床應用及療效分析. 中國胸心血管外科臨床雜志, 2010, 17(6): 503-505.
15.	王炯, 張純, 李治安, 等. 超聲心動圖觀察二尖瓣成形術治療二尖瓣關閉不全的近期療效. 中國醫學影像技術, 2005, 21(6): 883-886.
16.	Sayilir S, Ergün G, Ekiz T. Evaluation of ventricular diastolic function in patients with fibromyalgia syndrome. Arch Rheumatol, 2017, 33(2): 150-153.
17.	Kapustnik V, Kostuyk I, Shelest B, et al. Influence of left ventricular diastolic dysfunction and heart dyssynchrony on the course of arterial hypertension with comorbid pathology. Georgian Med News, 2018, (280-281): 75-80.
18.	顧立飛, 姚莉萍, 汪余勤, 等. 非酒精性脂肪性肝病對2型糖尿病患者心臟結構和功能改變的影響. 中華糖尿病雜志, 2016, 8(9): 541-547.

1. Parwani P, Avierinos JF, Levine RA, et al. Mitral valve prolapse: Multimodality imaging and genetic insights. Prog Cardiovasc Disney, 2017, 60(3): 361-369.
2. Zoghbi WA, Enriquez-Sarano M, Foster E, et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr, 2003, 16(7): 777-802.
3. Bonow RO, Carabello BA, Kanu C, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation, 2006, 114(5): e84-e231.
4. Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging, 2016, 17(12): 1321-1360.
5. 姜兆磊, 梅舉, 湯敏, 等. 改良人工腱索技術在右胸微創切口二尖瓣成形術中的應用及效果評價. 中國心血管病研究雜志, 2017, 15(5): 406-409.
6. 盧聰, 朱平, 吳若彬, 等. 二尖瓣成形術631例臨床分析. 南方醫科大學學報, 2009, 29(3): 556-558.
7. 喬瑞國, 黃信生, 汪川, 等. 二尖瓣后葉三角形切除成形術的療效分析. 中華胸心血管外科雜志, 2017, 33(10): 580-582.
8. 鮑春榮, 梅舉, 丁芳寶, 等. "緣對緣"技術防治二尖瓣成形術后收縮期前向運動及中遠期隨訪結果. 中國心血管病研究雜志, 2017, 15(7): 640-644.
9. 鄧學峰, 高長青. 二尖瓣成形術治療二尖瓣關閉不全. 中國胸心血管外科臨床雜志, 2008, 15(2): 134-137.
10. 郭穎, 王水云, 段雪晶, 等. 二尖瓣脫垂患者的臨床特點及預后分析. 中華心血管病雜志, 2017, 45(10): 848-851.
11. 孫海寧, 王巍, 宋云虎, 等. 二尖瓣成形術治療二尖瓣前葉脫垂的療效分析. 中國胸心血管外科臨床雜志, 2010, 17(4): 283-286.
12. 李紅巖, 韓勁松, 王輝山, 等. 退行性二尖瓣關閉不全行二尖瓣成形術305例臨床分析. 中國心血管病研究雜志, 2016, 14(10): 922-926.
13. 陳宏偉, 鄭理玲, 謝納新, 等. 二尖瓣成形術治療二尖瓣后葉脫垂. 中國心血管病研究雜志, 2012, 10(5): 329-332.
14. 張衛, 郭震, 葉偉. 二尖瓣成形術的臨床應用及療效分析. 中國胸心血管外科臨床雜志, 2010, 17(6): 503-505.
15. 王炯, 張純, 李治安, 等. 超聲心動圖觀察二尖瓣成形術治療二尖瓣關閉不全的近期療效. 中國醫學影像技術, 2005, 21(6): 883-886.
16. Sayilir S, Ergün G, Ekiz T. Evaluation of ventricular diastolic function in patients with fibromyalgia syndrome. Arch Rheumatol, 2017, 33(2): 150-153.
17. Kapustnik V, Kostuyk I, Shelest B, et al. Influence of left ventricular diastolic dysfunction and heart dyssynchrony on the course of arterial hypertension with comorbid pathology. Georgian Med News, 2018, (280-281): 75-80.
18. 顧立飛, 姚莉萍, 汪余勤, 等. 非酒精性脂肪性肝病對2型糖尿病患者心臟結構和功能改變的影響. 中華糖尿病雜志, 2016, 8(9): 541-547.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Changes of left ventricular structure and function after minimally invasive repair of mitral valve prolapse

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