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.
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5.	姜兆磊, 梅举, 汤敏, 等. 改良人工腱索技术在右胸微创切口二尖瓣成形术中的应用及效果评价. 中国心血管病研究杂志, 2017, 15(5): 406-409.
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7.	乔瑞国, 黄信生, 汪川, 等. 二尖瓣后叶三角形切除成形术的疗效分析. 中华胸心血管外科杂志, 2017, 33(10): 580-582.
8.	鲍春荣, 梅举, 丁芳宝, 等. "缘对缘"技术防治二尖瓣成形术后收缩期前向运动及中远期随访结果. 中国心血管病研究杂志, 2017, 15(7): 640-644.
9.	邓学峰, 高长青. 二尖瓣成形术治疗二尖瓣关闭不全. 中国胸心血管外科临床杂志, 2008, 15(2): 134-137.
10.	郭颖, 王水云, 段雪晶, 等. 二尖瓣脱垂患者的临床特点及预后分析. 中华心血管病杂志, 2017, 45(10): 848-851.
11.	孙海宁, 王巍, 宋云虎, 等. 二尖瓣成形术治疗二尖瓣前叶脱垂的疗效分析. 中国胸心血管外科临床杂志, 2010, 17(4): 283-286.
12.	李红岩, 韩劲松, 王辉山, 等. 退行性二尖瓣关闭不全行二尖瓣成形术305例临床分析. 中国心血管病研究杂志, 2016, 14(10): 922-926.
13.	陈宏伟, 郑理玲, 谢纳新, 等. 二尖瓣成形术治疗二尖瓣后叶脱垂. 中国心血管病研究杂志, 2012, 10(5): 329-332.
14.	张卫, 郭震, 叶伟. 二尖瓣成形术的临床应用及疗效分析. 中国胸心血管外科临床杂志, 2010, 17(6): 503-505.
15.	王炯, 张纯, 李治安, 等. 超声心动图观察二尖瓣成形术治疗二尖瓣关闭不全的近期疗效. 中国医学影像技术, 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.	顾立飞, 姚莉萍, 汪余勤, 等. 非酒精性脂肪性肝病对2型糖尿病患者心脏结构和功能改变的影响. 中华糖尿病杂志, 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, 梅举, 汤敏, 等. 改良人工腱索技术在右胸微创切口二尖瓣成形术中的应用及效果评价. 中国心血管病研究杂志, 2017, 15(5): 406-409.
6. 卢聪, 朱平, 吴若彬, 等. 二尖瓣成形术631例临床分析. 南方医科大学学报, 2009, 29(3): 556-558.
7. 乔瑞国, 黄信生, 汪川, 等. 二尖瓣后叶三角形切除成形术的疗效分析. 中华胸心血管外科杂志, 2017, 33(10): 580-582.
8. 鲍春荣, 梅举, 丁芳宝, 等. "缘对缘"技术防治二尖瓣成形术后收缩期前向运动及中远期随访结果. 中国心血管病研究杂志, 2017, 15(7): 640-644.
9. 邓学峰, 高长青. 二尖瓣成形术治疗二尖瓣关闭不全. 中国胸心血管外科临床杂志, 2008, 15(2): 134-137.
10. 郭颖, 王水云, 段雪晶, 等. 二尖瓣脱垂患者的临床特点及预后分析. 中华心血管病杂志, 2017, 45(10): 848-851.
11. 孙海宁, 王巍, 宋云虎, 等. 二尖瓣成形术治疗二尖瓣前叶脱垂的疗效分析. 中国胸心血管外科临床杂志, 2010, 17(4): 283-286.
12. 李红岩, 韩劲松, 王辉山, 等. 退行性二尖瓣关闭不全行二尖瓣成形术305例临床分析. 中国心血管病研究杂志, 2016, 14(10): 922-926.
13. 陈宏伟, 郑理玲, 谢纳新, 等. 二尖瓣成形术治疗二尖瓣后叶脱垂. 中国心血管病研究杂志, 2012, 10(5): 329-332.
14. 张卫, 郭震, 叶伟. 二尖瓣成形术的临床应用及疗效分析. 中国胸心血管外科临床杂志, 2010, 17(6): 503-505.
15. 王炯, 张纯, 李治安, 等. 超声心动图观察二尖瓣成形术治疗二尖瓣关闭不全的近期疗效. 中国医学影像技术, 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. 顾立飞, 姚莉萍, 汪余勤, 等. 非酒精性脂肪性肝病对2型糖尿病患者心脏结构和功能改变的影响. 中华糖尿病杂志, 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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