Restrictive mitral annuloplasty for functional XXXX : acute hemodynamics and serial echocardiography.

@entity1 @entity712 @entity339 @entity120 @entity299 @entity551
BACKGROUND: Long-term effects of restrictive mitral annuloplasty (RMA), especially on hemodynamics and left ventricular (LV) function in @entity1 with functional @entity339 ( @entity339 ), have not been fully investigated. METHODS AND RESULTS: From 1999 to 2008, 44 @entity1 with @entity712 and functional @entity339 underwent RMA with stringent downsizing of the mitral annulus. Serial echocardiography was performed to evaluate LV function (reverse remodeling), estimated @entity551 (PAP) and mitral valve geometry at baseline and at discharge, and annually thereafter. Cardiac catheterization was performed at baseline, and at discharge to evaluate acute hemodynamic change. There were 3 early deaths, and the 5-year survival rate was 78    8%. In 41 survivors the clinical symptoms, stratified according to New York Heart Association class, significantly improved after surgery. Postoperative cardiac catheterization showed significant unloading for left ventricle, as well as improvement in LV systolic function. Serial echocardiography showed that improvements in LV function and systolic PAP were sustained in the majority of @entity1 . Multivariate Cox regression analysis identified preoperative @entity120 (systolic PAP>60 mm Hg) as the significant predictor for postoperative adverse @entity299 . CONCLUSIONS: RMA for functional @entity339 resulted in sustained improvement of hemodynamics and LV function over time. Additional studies are needed to define the negative impact of preoperative @entity120 in @entity1 with this condition.
