Skip to main content
SpringerLink
Log in
Book cover

Heart Failure pp 193–197Cite as

Surgical Intervention on the Mitral and Tricuspid Valves in Patients with Left Ventricular Dysfunction and Heart Failure

  • Chapter
  • First Online:

  • 2570 Accesses

Part of the book series: Cardiovascular Medicine ((CVM))

Abstract

Patients with left ventricular dysfunction due to either an ischemic or non-ischemic etiology often present with mitral insufficiency, usually in the setting of a structurally normal valve. This “functional” mitral insufficiency has been previously described by Carpentier as Type III insufficiency whereby restricted leaflet motion during either diastole (IIIa) or systole (IIIb) renders the valve incompetent [1]. The management of Type IIIb mitral insufficiency remains controversial and two recent trials sponsored by the NIH have only partially improved our understanding of the surgical management of this pathology [2, 3]. In addition, patients with left ventricular dysfunction and severe mitral insufficiency may also present with pulmonary hypertension and secondary tricuspid insufficiency. Again, the management of functional tricuspid insufficiency remains controversial [4, 5].

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Carpentier A. Cardiac valve surgery (the French correction). J Thorac Cardiovasc Surg. 1983;86:323–37.

    CAS  PubMed  Google Scholar 

  2. Michler RE, Smith PK, Parides MK, et al. Two year outcomes of surgical treatment of moderate ischemic mitral regurgitation. N Engl J Med. 2016;374:1932–41.

    Google Scholar 

  3. Goldstein DJ, Moskowitz AJ, Gelijns AC, et al. Two year outcomes of surgical treatment of severe ischemic mitral regurgitation. N Engl J Med. 2016;374:344–53.

    Google Scholar 

  4. Redondo Palancios A, Lopez Menendez J, Miguelena Hycka J, et al. Which type of valve should we use in tricuspid position? Long term comparison between mechanical and biological valves. J Cardiovasc Surg. 2016;58(5):739–46. epub ahead of print.

    Google Scholar 

  5. Teman NR, Huffman LC, Krajacic M, Pagani FD, Haft JW, Bolling SF. Prophylactic tricuspid repair for functional tricuspid insufficiency. Ann Thor Surg. 2014;97:1520–4.

    Article  Google Scholar 

  6. Haddad F, Denault A, Couture P, et al. Right ventricular performance index predicts perioperative mortality or circulatory failure in high risk valvular surgery. J Am Soc Echocardiogr. 2007;20:1065–72.

    Article  Google Scholar 

  7. Pilarczyk K, Boening A, Jakob H, et al. Preoperative intra-aortic counterpulsation in high-risk patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials. Eur J Cardiothorac Surg. 2016;49:5–17.

    Article  Google Scholar 

  8. Jeganathan R, Maganti M, Badiwala MV, Rao V. Concomitant mitral valve surgery in patients undergoing surgical ventricular reconstruction for ischemic cardiomyopathy. Eur J Cardiothorac Surg. 2013;43:1000–5.

    Article  Google Scholar 

  9. Deja MA, Grayburn PA, Sun B, et al. Influence of mitral regurgitation repair on survival in the surgical treatment for ischemic heart failure trial. Circulation. 2012;125:2639–48.

    Article  Google Scholar 

  10. Maganti M, Badiwala MV, Sheikh A, et al. Predictors of low output syndrome after isolated mitral valve surgery. J Thorac Cardiovasc Surg. 2010;140:790–6.

    Article  Google Scholar 

  11. Romano MA, Bolling SF. Update on mitral repair in dilated cardiomyopathy. J Card Surg. 2004;19:396–400.

    Article  Google Scholar 

  12. Kron IL, Acker MA, Adams DH, for the AATS Ischemic Mitral Regurgitation Consensus Guidelines Writing Committee. 2015 the American Association for Thoracic Surgery consensus guidelines: ischemic mitral valve regurgitation. J Thorac Cardiovasc Surg. 2016;151:940–56.

    Article  Google Scholar 

  13. Kron IL, Hung J, Overbey JR, et al. Predicting recurrent mitral regurgitation after mitral valve repair for severe ischemic mitral regurgitation. J Thorac Cardiovasc Surg. 2015;149:752–61.

    Article  Google Scholar 

  14. Capoulade R, Zeng X, Overbey JR, et al. Impact of left ventricular to mitral valve ring mismatch on recurrent ischemic mitral regurgitation after ring annuloplasty. Circulation. 2016;134:1247–56.

    Article  CAS  Google Scholar 

  15. Badiwala MV, Verma S, Rao V. Surgical management of ischemic mitral regurgitation. Circulation. 2009;120:1287–93.

    Article  Google Scholar 

  16. Messas E, Pouzet B, Touchot B, et al. Efficacy of chordal cutting to relieve chronic persistent ischemic mitral regurgitation. Circulation. 2003;108(Suppl1):I-111-115.

    Google Scholar 

  17. Borger MA, Murphy PM, Alam A, et al. Initial results of the chordal-cutting operation for ischemic mitral regurgitation. J Thorac Cardiovasc Surg. 2007;133:1483–92.

    Article  Google Scholar 

  18. Nappi F, Lusini M, Spadaccio C, et al. Papillary muscle approximation versus restrictive annuloplasty alone for severe ischemic mitral regurgitation: a randomized trial. J Am Coll Cardiol. 2016;24:2334–46.

    Article  Google Scholar 

  19. Nappi F, Spadaccio C, Nenna A, et al. Is subvalvular repair worthwhile in severe ischemic mitral regurgitation? Subanalysis of the papillary muscle approximation trial. J Thorac Cardiovasc Surg 2016.; epub ahead of print.

    Google Scholar 

  20. Kron IL, Green GR, Cope JT. Surgical relocation of the posterior papillary muscle in chronic ischemic mitral regurgitation. Ann Thorac Surg. 2002;74:600–1.

    Article  Google Scholar 

  21. Chikwe J, Itagaki S, Anyanwu A, Adams DH. Impact of concomitant tricuspid annuloplasty on tricuspid regurgitation, right ventricular function and pulmonary hypertension after repair of mitral valve prolapse. J Am Coll Cardiol. 2015;65:1931–8.

    Article  Google Scholar 

  22. Pfannmuller B, Doenst T, Eberhard K, Seeburger J, Borger MA, Mohr FW. Increased risk of dehiscence after tricuspid valve repair with rigid annuloplasty rings. J Thorac Cardiovasc Surg. 2012;143:1050–5.

    Article  Google Scholar 

  23. Tang GH, David TE, Singh SK, Maganti MD, Armstrong S, Borger MA. Tricuspid valve repair with an annuloplasty ring results in improved long-term outcomes. Circulation. 2006;114(suppl 1):577–81.

    Google Scholar 

  24. Kay JH, Maselli-Campagna G, Tsuji H. Surgical treatment of tricuspid insufficiency. Ann Surg. 1965;162:53–8.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Munk Professor in Advanced Cardiac Therapeutics, Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, ON, Canada

    Vivek Rao

Authors
  1. Vivek Rao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vivek Rao .

Editor information

Editors and Affiliations

  1. Division of Cardiology, Department of Medicine, University of Cincinnati, Cincinnati, OH, USA

    David S. Feldman

  2. Clinic im Park, Cardiovascular Center Zürich, Hirslanden Zurich, Switzerland

    Paul Mohacsi

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Rao, V. (2019). Surgical Intervention on the Mitral and Tricuspid Valves in Patients with Left Ventricular Dysfunction and Heart Failure. In: Feldman, D., Mohacsi, P. (eds) Heart Failure. Cardiovascular Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-98184-0_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-98184-0_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-98182-6

  • Online ISBN: 978-3-319-98184-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation