Impact of left atrium plication on chronic heart failure with atrial functional mitral regurgitation.

IF 0.7 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2024-01-01 Epub Date: 2023-08-19 DOI:10.1007/s12055-023-01569-6

Kosuke Nakamae, Takashi Oshitomi, Hideyuki Uesugi, Ichiro Ideta, Kentaro Takaji, Toshiharu Sassa, Hidetaka Murata, Masataka Hirota

{"title":"Impact of left atrium plication on chronic heart failure with atrial functional mitral regurgitation.","authors":"Kosuke Nakamae, Takashi Oshitomi, Hideyuki Uesugi, Ichiro Ideta, Kentaro Takaji, Toshiharu Sassa, Hidetaka Murata, Masataka Hirota","doi":"10.1007/s12055-023-01569-6","DOIUrl":null,"url":null,"abstract":"Purpose: We hypothesized that a giant left atrium may oppress the posterior left ventricle and aggravate diastolic dysfunction and heart failure. We evaluated the effect of left atrial plication (LAP) on atrial functional mitral regurgitation.Methods: We retrospectively reviewed patients who underwent LAP for atrial functional mitral regurgitation at our institution between January 2017 and December 2021. Early outcomes, follow-up echocardiography data, and heart failure indicators were compared.Results: Eighteen patients were divided into two groups: LAP + (n = 9) or LAP- (n = 9). There were no significant differences in patient characteristics and preoperative echocardiographic parameters, except for the preoperative New York Heart Association classification. Operative (505.7 [standard deviation: 100.0] minutes vs. 382.9 [standard deviation: 58.1] minutes, P = .0055) and cardiopulmonary bypass times (335.6 [standard deviation: 50.4] minutes vs. 246.9 [standard deviation: 62.7] minutes, P = .0044) were significantly longer in the LAP + group. No in-hospital mortalities were observed in both groups. The postoperative left atrial volume was significantly reduced in the LAP + group, and mitral regurgitation was controlled at less than mild levels in both groups. At follow-up, the left ventricular end-diastolic volume was reduced significantly in the LAP + group. Brain natriuretic peptide, cardiothoracic ratio, and the New York Heart Association classification were improved in the LAP + group.Conclusions: Additional left atrial plication contributes to the control of atrial functional mitral regurgitation and heart failure at a later stage. A careful long-term follow-up is needed as re-expansion of the left atrium is possible.Supplementary information: The online version contains supplementary material available at 10.1007/s12055-023-01569-6.","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10728386/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Thoracic and Cardiovascular Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12055-023-01569-6","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/19 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: We hypothesized that a giant left atrium may oppress the posterior left ventricle and aggravate diastolic dysfunction and heart failure. We evaluated the effect of left atrial plication (LAP) on atrial functional mitral regurgitation.

Methods: We retrospectively reviewed patients who underwent LAP for atrial functional mitral regurgitation at our institution between January 2017 and December 2021. Early outcomes, follow-up echocardiography data, and heart failure indicators were compared.

Results: Eighteen patients were divided into two groups: LAP + (n = 9) or LAP- (n = 9). There were no significant differences in patient characteristics and preoperative echocardiographic parameters, except for the preoperative New York Heart Association classification. Operative (505.7 [standard deviation: 100.0] minutes vs. 382.9 [standard deviation: 58.1] minutes, P = .0055) and cardiopulmonary bypass times (335.6 [standard deviation: 50.4] minutes vs. 246.9 [standard deviation: 62.7] minutes, P = .0044) were significantly longer in the LAP + group. No in-hospital mortalities were observed in both groups. The postoperative left atrial volume was significantly reduced in the LAP + group, and mitral regurgitation was controlled at less than mild levels in both groups. At follow-up, the left ventricular end-diastolic volume was reduced significantly in the LAP + group. Brain natriuretic peptide, cardiothoracic ratio, and the New York Heart Association classification were improved in the LAP + group.

Conclusions: Additional left atrial plication contributes to the control of atrial functional mitral regurgitation and heart failure at a later stage. A careful long-term follow-up is needed as re-expansion of the left atrium is possible.

Supplementary information: The online version contains supplementary material available at 10.1007/s12055-023-01569-6.

查看原文本刊更多论文

左心房折叠术对慢性心力衰竭伴心房功能性二尖瓣反流的影响

目的：我们假设巨大的左心房可能会压迫左心室后部，加重舒张功能障碍和心力衰竭。我们评估了左心房成形术（LAP）对心房功能性二尖瓣反流的影响：我们回顾性研究了2017年1月至2021年12月期间在我院接受左心房成形术治疗心房功能性二尖瓣反流的患者。比较了早期结果、随访超声心动图数据和心衰指标：18名患者分为两组：LAP + 组（9 人）或 LAP- 组（9 人）。除术前纽约心脏协会分级外，患者特征和术前超声心动图参数无明显差异。LAP + 组的手术时间（505.7 [标准差：100.0] 分钟 vs. 382.9 [标准差：58.1] 分钟，P = .0055）和心肺旁路时间（335.6 [标准差：50.4] 分钟 vs. 246.9 [标准差：62.7] 分钟，P = .0044）明显更长。两组均无院内死亡病例。LAP + 组的术后左心房容积明显缩小，两组的二尖瓣反流均控制在轻度以下。随访时，LAP + 组的左心室舒张末期容积明显缩小。LAP + 组的脑钠肽含量、心胸比率和纽约心脏协会分级均有所改善：结论：附加左心房成形术有助于控制心房功能性二尖瓣反流和后期心力衰竭。由于左心房有可能再次扩张，因此需要长期仔细随访：在线版本包含补充材料，可在 10.1007/s12055-023-01569-6上查阅。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Indian Journal of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

1.20

自引率

14.30%

发文量

141

期刊介绍： The primary aim of the Indian Journal of Thoracic and Cardiovascular Surgery is education. The journal aims to dissipate current clinical practices and developments in the area of cardiovascular and thoracic surgery. This includes information on cardiovascular epidemiology, aetiopathogenesis, clinical manifestation etc. The journal accepts manuscripts from cardiovascular anaesthesia, cardiothoracic and vascular nursing and technology development and new/innovative products.The journal is the official publication of the Indian Association of Cardiovascular and Thoracic Surgeons which has a membership of over 1000 at present.DescriptionThe journal is the official organ of the Indian Association of Cardiovascular-Thoracic Surgeons. It was started in 1982 by Dr. Solomon Victor and ws being published twice a year up to 1996. From 2000 the editorial office moved to Delhi. From 2001 the journal was extended to quarterly and subsequently four issues annually have been printed out at time and regularly without fail. The journal receives manuscripts from members and non-members and cardiovascular surgeons. The manuscripts are peer reviewed by at least two or sometimes three or four reviewers who are on the panel. The manuscript process is now completely online. Funding the journal comes partially from the organization and from revenue generated by subscription and advertisement.