A successful treatment of ischemic cardiomyopathy associated with left ventricular aneurysm and chronic ischaemic mitral regurgitation (RCD code: III-1B.9.o).
Full Text:
Abstract
Complications of myocardial infarction (MI) such as left ventricular aneurysm, chronic ischaemic mitral regurgitation (CIMR) and heart failure are associated with a poor prognosis. The management of complex defects is challenging and requires an individualized strategy. We describe a case of 44-year-old male with multiple complications of MI including heart failure with reduced ejection fraction, left ventricular aneurysm and severe CIMR. We present complex approach, aimed at correcting various components of ischemic cardiomyopathy: relieving ischemia, reducing left ventricular wall tension, reducing volume overload and pulmonary hypertension by mitral valve surgery and left ventricular reconstruction (also known as the Dor procedure). In this case report, we describe the crucial role of echocardiography and magnetic resonance imaging before surgery.
Keywords
References
Enriquez-Sarano M, Akins CW, Vahanian A. Mitral regurgitation. Lancet, 2009; 373: 1382–1394.
Rusted IE, Schiefly CH, Edwards JE. Studies of the mitral valve: I. Anatomical features of the normal mitral valve and associated structures. Circulation, 1952; 6: 825–831.
Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg, 2012; 42: 1-44.
Lancellotti P, Gerard P, Pierard L. Long term outcome of patients with heart failure and dynamic functional mitral regurgitation. Eur Heart J, 2005; 26:1528–1532.
Levy D, Kenchaiah S, Larson MG et al. Long-term trends in the incidence of and survival with heart failure. Framingham Heart Study. N Engl J Med, 2002; 347: 1397-402.
Acker MA, Jessup M, Bolling SF et al. Mitral valve repair in heart failure: five-year follow-up from the mitral valve replacement stratum of the Acorn randomized trial. J Thorac Cardiovasc Surg, 2011; 142: 569–574.
Grigioni F, Enriquez-Sarano M, Zehr KJ et al. Ischemic mitral regurgitation: long-term outcome and prognostic implications with quantitative Doppler assessment. Circulation, 2001; 103: 1759–1764.
Tracz W, Leśniak-Sobelga A, Podolec P et al. Niedomykalność zastawki mitralnej. In: Tracz W, Podolec P, Hoffman P eds. Echokardiografia praktyczna, tom II. Wyd. I. Medycyna Praktyczna, Kraków 2005; 105–117.
Tracz W, Leśniak-Sobelga A, Siniawski H et al. Niedokrwienna niedomykalność zastawki mitralnej. In: Tracz W, Podolec P, Hoffman P eds. Echokardiografia praktyczna, tom III. Wyd. I. Medycyna Praktyczna, Kraków 2005; 83–94.
Lancellotti P, Moura L, Pierard LA et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). Eur J Echocardiogr, 2010; 11: 307–332.
Loop FD, Effler DB, Webster JS et al. Posterior ventricular aneurysm, etiologic factors and result of surgical treatment. N Eng J of Med, 1973; 41: 302-06.
Nagle RE, Williams DO. Proceedings: Natural history of ventricular aneurysm without surgical treatment. Br Heart J, 1974; 36:1037.
Dubnow MH, Burchell HB, Titus JL. Postinfarction ventricular aneurysm. A clinicomorphologic and electrocardiographic study of 80 cases. Am Heart J, 1965; 70:753.
Ando S, Kadokami T, Momii H et al. Left ventricular false-pseudo and pseudo aneurysm: serial observations by cardiac magnetic resonance imaging. Intern Med, 2007; 46: 181-5.
Lundblad R, Abdelnoor M, Svennevig JL. Surgery for left ventricular aneurysm: early and late survival after simple linear repair and endoventricular patch plasty. J Thorac Cardiovasc Surg 2004;128:449–56.
Bolooki H, DeMarchena E, Mallon SM et al. Factors affecting late survival after surgical remodelling of left ventricular aneurysm. J Thorac Cardiovasc Surg, 2003; 126: 374-85.
Mickleborough LL, Carson S, Ivanov J. Repair of dyskinetic or akinetic left ventricular aneurysm: results obtained with a modified linear closure. J Thorac Cardiovasc Surg, 2001; 121:675.
Eric J. Velazquez, Kerry L. Lee, Marek A. Deja et al. Coronary-Artery Bypass Surgery in Patients with Left Ventricular Dysfunction. N Engl J Med, 2011; 364:1607-1616
Madani MM. Mitral valve repair in the treatment of heart failure. Curr Treat Options Cardiovasc Med, 2004;6:305–11
Hausmann H, Siniawski H, Hetzer R. Mitral valve reconstruction and replacement for ischemic mitral insufficiency: seven years follow up. J Heart Valve Dis, 1999; 8: 536–542.
Acker MA, Parides MK, Perrault LP et al. Mitral-valve repair versus replacement for severe ischemic mitral regurgitation. NEJM, 2014; 370: 23-32.
Wu AH, Aaronson KD, Bolling SF et al. Impact of mitral valve annuloplasty on mortality risk in patients with mitral regurgitation and left ventricular systolic dysfunction. J Am Coll Cardiol, 2005; 45: 381–387.
Ciarka A, Braun J, Delgado V et al. Predictors of mitral regurgitation recurrence in patients with heart failure undergoing mitral valve annuloplasty. Am J Cardiol, 2010; 106: 395–401.
DOI: http://dx.doi.org/10.20418%2Fjrcd.vol3no4.271
Refbacks
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »
- »