TY - JOUR
T1 - The GeoForm annuloplasty ring for the surgical treatment of functional mitral regurgitation in advanced dilated cardiomyopathy
AU - De Bonis, Michele
AU - Taramasso, Maurizio
AU - Grimaldi, Antonio
AU - Maisano, Francesco
AU - Calabrese, Maria Chiara
AU - Verzini, Alessandro
AU - Ferrara, David
AU - Alfieri, Ottavio
PY - 2011/8
Y1 - 2011/8
N2 - Objective: To assess the results of the three-dimensional (3D)-shaped GeoForm ring for the treatment of functional mitral regurgitation (FMR). Methods: Seventy-four patients with severe FMR and systolic dysfunction underwent GeoForm ring implantation. Forty-six patients (62%) were in the New York Heart Association (NYHA) class III-IV. Concomitant procedures were coronary artery bypass grafting (CABG) (33 patients (pts)), tricuspid repair (23 pts), atrial fibrillation ablation (20 pts), aortic valve replacement (eight pts) and left-ventricular (LV) reconstruction (five pts). Results: Hospital mortality was 9%. Three more patients died after hospital discharge. Overall survival was 81.1±6.6% at 3.5 years. The 67 hospital survivors underwent clinical and echocardiographic follow-up at a mean follow-up period of 1.9±1.25 years (median 1.7 years). MR was absent or mild in 83% of the patients (56/67), moderate in 7% (5/67), and moderate to severe in the remaining 9% (6/67). At 3.5 years, overall freedom from MR≥3+ was 85.1±8% and freedom from MR≥2+ was 75.1±8.6%. Statistical analysis identified preoperative asymmetric tethering with prevalent restricted motion of the posterior leaflet as the only predictor of recurrence of MR≥2+ (hazard ratio (HR) 6.1, p=0.005). Reverse LV remodeling was demonstrated in 31 of the 54 patients eligible for this specific analysis (31/54, 57%): Both LV end-diastolic and end-systolic volumes indexed significantly decreased (both p=0.0001) as well as systolic pulmonary artery pressure (SPAP) (p=0.006). Ejection fraction increased from 33±8% to 43±8% (p2 and did not change during stress. Cardiac output significantly increased in all patients during exercise. Although mean and peak transmitral gradients were 3.3±1.3 and 8.1±2.2mmHg at rest and 6.6±2.5 and 14.8±3.9mmHg under stress, respectively (both p
AB - Objective: To assess the results of the three-dimensional (3D)-shaped GeoForm ring for the treatment of functional mitral regurgitation (FMR). Methods: Seventy-four patients with severe FMR and systolic dysfunction underwent GeoForm ring implantation. Forty-six patients (62%) were in the New York Heart Association (NYHA) class III-IV. Concomitant procedures were coronary artery bypass grafting (CABG) (33 patients (pts)), tricuspid repair (23 pts), atrial fibrillation ablation (20 pts), aortic valve replacement (eight pts) and left-ventricular (LV) reconstruction (five pts). Results: Hospital mortality was 9%. Three more patients died after hospital discharge. Overall survival was 81.1±6.6% at 3.5 years. The 67 hospital survivors underwent clinical and echocardiographic follow-up at a mean follow-up period of 1.9±1.25 years (median 1.7 years). MR was absent or mild in 83% of the patients (56/67), moderate in 7% (5/67), and moderate to severe in the remaining 9% (6/67). At 3.5 years, overall freedom from MR≥3+ was 85.1±8% and freedom from MR≥2+ was 75.1±8.6%. Statistical analysis identified preoperative asymmetric tethering with prevalent restricted motion of the posterior leaflet as the only predictor of recurrence of MR≥2+ (hazard ratio (HR) 6.1, p=0.005). Reverse LV remodeling was demonstrated in 31 of the 54 patients eligible for this specific analysis (31/54, 57%): Both LV end-diastolic and end-systolic volumes indexed significantly decreased (both p=0.0001) as well as systolic pulmonary artery pressure (SPAP) (p=0.006). Ejection fraction increased from 33±8% to 43±8% (p2 and did not change during stress. Cardiac output significantly increased in all patients during exercise. Although mean and peak transmitral gradients were 3.3±1.3 and 8.1±2.2mmHg at rest and 6.6±2.5 and 14.8±3.9mmHg under stress, respectively (both p
KW - Dilated cardiomyopathy
KW - Functional mitral regurgitation
KW - Undersized mitral annuloplasty
UR - http://www.scopus.com/inward/record.url?scp=79960243029&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79960243029&partnerID=8YFLogxK
U2 - 10.1016/j.ejcts.2010.11.048
DO - 10.1016/j.ejcts.2010.11.048
M3 - Article
C2 - 21232967
AN - SCOPUS:79960243029
VL - 40
SP - 488
EP - 495
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
SN - 1010-7940
IS - 2
ER -