Edge-to-edge mitral valve repair without ring annuloplasty for acute ischemic mitral regurgitation

Tomasz A. Timek, Sten L. Nielsen, David T. Lai, Frederick (Fred) Tibayan, David Liang, Filiberto Rodriguez, George T. Daughters, Neil B. Ingels, D. Craig Miller

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background - Alfieri edge-to-edge mitral repair has been used clinically with ring annuloplasty to correct ischemic mitral regurgitation (IMR), but its efficacy without concomitant ring annuloplasty has not been described in this setting. Methods - Seventeen sheep underwent implantation of 9 radiopaque markers on the left ventricle, 8 on the mitral annulus (MA), 1 on each papillary muscle (PM) tip, and 1 on the anterior and posterior leaflet edges near the anterior and posterior commissures. Alfieri repair was performed in 7 animals, and 10 were controls. Biplane videofluoroscopy and transesophageal echocardiography (TEE) were performed (open chest) before and continuously during left circumflex coronary artery occlusion to induce acute IMR. MA area (MAA), anterior (APM), and posterior (PPM) papillary muscle tip distances to midseptal MA ("saddle horn"), and distance of each leaflet marker to the mitral annular plane were calculated from 3-dimensional marker coordinates at end-systole (ES). Results - Severity of IMR was not different between groups (+1.9±0.7 versus +1.4±0.5 for Control and Alfieri, respectively; P=not significant [NS]). Mitral annular area (MAA; 21±15 versus 19±9%; P=NS) and septal-lateral (SL) annular diameter (12±6 versus 12±11%; P=NS) increased similarly during ischemia. While PPM-saddle horn distance increased in both groups (1.5±1.3 and 1.6±1.4 mm for Control and Alfieri, respectively; P

Original languageEnglish (US)
JournalCirculation
Volume108
Issue number10 SUPPL.
StatePublished - Sep 9 2003
Externally publishedYes

Fingerprint

Mitral Valve Insufficiency
Mitral Valve
Papillary Muscles
Horns
Systole
Coronary Occlusion
Transesophageal Echocardiography
Heart Ventricles
Sheep
Coronary Vessels
Thorax
Ischemia

Keywords

  • Annuloplasty
  • Coronary artery disease
  • Ischemic mitral regurgitation
  • Mitral regurgitation
  • Mitral valve repair

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Timek, T. A., Nielsen, S. L., Lai, D. T., Tibayan, F. F., Liang, D., Rodriguez, F., ... Miller, D. C. (2003). Edge-to-edge mitral valve repair without ring annuloplasty for acute ischemic mitral regurgitation. Circulation, 108(10 SUPPL.).

Edge-to-edge mitral valve repair without ring annuloplasty for acute ischemic mitral regurgitation. / Timek, Tomasz A.; Nielsen, Sten L.; Lai, David T.; Tibayan, Frederick (Fred); Liang, David; Rodriguez, Filiberto; Daughters, George T.; Ingels, Neil B.; Miller, D. Craig.

In: Circulation, Vol. 108, No. 10 SUPPL., 09.09.2003.

Research output: Contribution to journalArticle

Timek, TA, Nielsen, SL, Lai, DT, Tibayan, FF, Liang, D, Rodriguez, F, Daughters, GT, Ingels, NB & Miller, DC 2003, 'Edge-to-edge mitral valve repair without ring annuloplasty for acute ischemic mitral regurgitation', Circulation, vol. 108, no. 10 SUPPL..
Timek TA, Nielsen SL, Lai DT, Tibayan FF, Liang D, Rodriguez F et al. Edge-to-edge mitral valve repair without ring annuloplasty for acute ischemic mitral regurgitation. Circulation. 2003 Sep 9;108(10 SUPPL.).
Timek, Tomasz A. ; Nielsen, Sten L. ; Lai, David T. ; Tibayan, Frederick (Fred) ; Liang, David ; Rodriguez, Filiberto ; Daughters, George T. ; Ingels, Neil B. ; Miller, D. Craig. / Edge-to-edge mitral valve repair without ring annuloplasty for acute ischemic mitral regurgitation. In: Circulation. 2003 ; Vol. 108, No. 10 SUPPL.
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abstract = "Background - Alfieri edge-to-edge mitral repair has been used clinically with ring annuloplasty to correct ischemic mitral regurgitation (IMR), but its efficacy without concomitant ring annuloplasty has not been described in this setting. Methods - Seventeen sheep underwent implantation of 9 radiopaque markers on the left ventricle, 8 on the mitral annulus (MA), 1 on each papillary muscle (PM) tip, and 1 on the anterior and posterior leaflet edges near the anterior and posterior commissures. Alfieri repair was performed in 7 animals, and 10 were controls. Biplane videofluoroscopy and transesophageal echocardiography (TEE) were performed (open chest) before and continuously during left circumflex coronary artery occlusion to induce acute IMR. MA area (MAA), anterior (APM), and posterior (PPM) papillary muscle tip distances to midseptal MA ({"}saddle horn{"}), and distance of each leaflet marker to the mitral annular plane were calculated from 3-dimensional marker coordinates at end-systole (ES). Results - Severity of IMR was not different between groups (+1.9±0.7 versus +1.4±0.5 for Control and Alfieri, respectively; P=not significant [NS]). Mitral annular area (MAA; 21±15 versus 19±9{\%}; P=NS) and septal-lateral (SL) annular diameter (12±6 versus 12±11{\%}; P=NS) increased similarly during ischemia. While PPM-saddle horn distance increased in both groups (1.5±1.3 and 1.6±1.4 mm for Control and Alfieri, respectively; P",
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T1 - Edge-to-edge mitral valve repair without ring annuloplasty for acute ischemic mitral regurgitation

AU - Timek, Tomasz A.

AU - Nielsen, Sten L.

AU - Lai, David T.

AU - Tibayan, Frederick (Fred)

AU - Liang, David

AU - Rodriguez, Filiberto

AU - Daughters, George T.

AU - Ingels, Neil B.

AU - Miller, D. Craig

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Y1 - 2003/9/9

N2 - Background - Alfieri edge-to-edge mitral repair has been used clinically with ring annuloplasty to correct ischemic mitral regurgitation (IMR), but its efficacy without concomitant ring annuloplasty has not been described in this setting. Methods - Seventeen sheep underwent implantation of 9 radiopaque markers on the left ventricle, 8 on the mitral annulus (MA), 1 on each papillary muscle (PM) tip, and 1 on the anterior and posterior leaflet edges near the anterior and posterior commissures. Alfieri repair was performed in 7 animals, and 10 were controls. Biplane videofluoroscopy and transesophageal echocardiography (TEE) were performed (open chest) before and continuously during left circumflex coronary artery occlusion to induce acute IMR. MA area (MAA), anterior (APM), and posterior (PPM) papillary muscle tip distances to midseptal MA ("saddle horn"), and distance of each leaflet marker to the mitral annular plane were calculated from 3-dimensional marker coordinates at end-systole (ES). Results - Severity of IMR was not different between groups (+1.9±0.7 versus +1.4±0.5 for Control and Alfieri, respectively; P=not significant [NS]). Mitral annular area (MAA; 21±15 versus 19±9%; P=NS) and septal-lateral (SL) annular diameter (12±6 versus 12±11%; P=NS) increased similarly during ischemia. While PPM-saddle horn distance increased in both groups (1.5±1.3 and 1.6±1.4 mm for Control and Alfieri, respectively; P

AB - Background - Alfieri edge-to-edge mitral repair has been used clinically with ring annuloplasty to correct ischemic mitral regurgitation (IMR), but its efficacy without concomitant ring annuloplasty has not been described in this setting. Methods - Seventeen sheep underwent implantation of 9 radiopaque markers on the left ventricle, 8 on the mitral annulus (MA), 1 on each papillary muscle (PM) tip, and 1 on the anterior and posterior leaflet edges near the anterior and posterior commissures. Alfieri repair was performed in 7 animals, and 10 were controls. Biplane videofluoroscopy and transesophageal echocardiography (TEE) were performed (open chest) before and continuously during left circumflex coronary artery occlusion to induce acute IMR. MA area (MAA), anterior (APM), and posterior (PPM) papillary muscle tip distances to midseptal MA ("saddle horn"), and distance of each leaflet marker to the mitral annular plane were calculated from 3-dimensional marker coordinates at end-systole (ES). Results - Severity of IMR was not different between groups (+1.9±0.7 versus +1.4±0.5 for Control and Alfieri, respectively; P=not significant [NS]). Mitral annular area (MAA; 21±15 versus 19±9%; P=NS) and septal-lateral (SL) annular diameter (12±6 versus 12±11%; P=NS) increased similarly during ischemia. While PPM-saddle horn distance increased in both groups (1.5±1.3 and 1.6±1.4 mm for Control and Alfieri, respectively; P

KW - Annuloplasty

KW - Coronary artery disease

KW - Ischemic mitral regurgitation

KW - Mitral regurgitation

KW - Mitral valve repair

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M3 - Article

VL - 108

JO - Circulation

JF - Circulation

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