ALGORITHM FOR THE DIAGNOSTIC SEARCH OF STRUCTURAL AND FUNCTIONAL CHANGES IN THE MITRAL VALVE IN MITRAL INSUFFICIENCY OF ISCHEMIC GENESIS

Authors:

Abstract:

Established features of diagnostic data that influence the choice of surgical tactics for mitral valve correction. It was found that myocardial infarction was present in the anamnesis significantly more often in patients of the control group (p=0.04, χ2=4.09). More pronounced structural and anatomical changes of the mitral valve were established, which had statistical significance in patients of the control group, namely: prolapse of the leaflets: anterior (p=0.04; χ2=4.0) and both leaflets (p=0.02; χ2=5.24); frequency of calcinosis (р=0.006; χ2=7.58); calcinosis of the ring (p=0.01; χ2=5.58); reverse blood flow of a pronounced degree: (++)/(+++), (p=0.002; χ2=10.03) and very pronounced (+++)/(++++), (p=0.04; χ2=4.03) and severe mitral valve insufficiency (p=0.03; χ2=4.69).

Keywords:

ischemic heart disease mitral regurgitation myocardial infarction mitral insufficiency operations on the mitral valve

References:

1. Báez-Ferrer N, Izquierdo-Gómez MM, Marí-López B, Montoto-López J, Duque-Gómez A, García-Niebla J, et al. Clinical manifestations, diagnosis, and treatment of ischemic mitral regurgitation: a review. J Thorac Dis. 2018 Dec;10(12):6969–6986. doi: 10.21037/jtd.2018.10.64.
2. Bothe W, Kvitting JP, Rausch MK, TimikTA, Swanson JC, Liang DH et al. Do annuloplasty rings designed to treat ischemic/functional mitral regurgitation alter left-ventricular dimensions in the acutely ischemic ovine heart?. J Thorac Cardiovasc Surg. 2019;158(4):1058–1068. doi:10.1016/j.jtcvs.2018.12.077.
3. Brescia AA, Watt TMF, Bolling SF. Ischemic Mitral Regurgitation: Current Understanding and Surgical Options. Indian J Thorac Cardiovasc Surg. 2020;36(Suppl 1):27–33. doi:10.1007/s12055-019–00811–4.
4. Fukui T, Takanashi S, Tabata M, Hosoda Y. Mild or moderate ischemic mitral regurgitation in patients undergoing off-pump coronary artery bypass grafting. J Card Surg. 2007;22(6):480–485. doi:10.1111/j.1540–8191.2007.00464.x.
5. Kusunose K, Obuchowski NA, Gillinov M, Popovic ZB, Flamm SD, Griffin BP et al. Predictors of Mortality in Patients With Severe Ischemic Cardiomyopathy Undergoing Surgical Mitral Valve Intervention. J Am Heart Assoc. 2017 Nov 17;6(11):e007163. doi: 10.1161/JAHA.117.007163.
6. Kwon DH, Huang S, Turkmani M, Salam D, Al-Dieri D, Ming Wang TK et al. Cardiac MRI-Enriched Phenomapping Classification and Differential Treatment Outcomes in Patients With Ischemic Cardiomyopathy. Circ Cardiovasc Imaging. 2024;17(4):e016006. doi:10.1161/CIRCIMAGING.123.016006.
7. Mariscalco G, Serraino GF, Musumeci F. Mitral valve repair: when the ring is not enough. J Cardiovasc Med (Hagerstown). 2018;19 Suppl 1:e93–e95. doi:10.2459/JCM.0000000000000587.
8. Mil-Homens Luz F, Amorim MJ. ISCHEMIC MITRAL REGURGITATION – TO REPAIR OR REPLACE? LOOKING BEYOND THE VALVE. Port J Card Thorac Vasc Surg. 2022;29(1):25–34. Published 2022 Apr 11. doi:10.48729/pjctvs.253.
9. Shaposhnyk OA, Prykhodko NP, Savchenko LV, Shevchenko TI, Sorokina SI, Yakymyshyna LI. Clinical and diagnostic aspects of managing patients with valvular heart disease. World of Medicine and Biology. 2022. №2(80): 178–83. http://dx.doi.org/10.26724/2079-8334-2022-2-80-178-183.
10. Teng Z, Ma X, Zhang Q, Yan Y, Chi M, Songtao H, et al. Additional mitral valve procedure and coronary artery bypass grafting versus isolated coronary artery bypass grafting in the management of significant functional ischemic mitral regurgitation: a meta-analysis. J Cardiovasc Surg (Torino). 2017;58(1):121–130. doi:10.23736/S0021-9509.16.08852-2
11. Varma PK, Krishna N, Jose RL, Madkaiker AN. Ischemic mitral regurgitation. Ann Card Anaesth. 2017 Oct–Dec;20(4):432–439. doi: 10.4103/aca.ACA_58_17.

Publication:

«World of Medicine and Biology» Vol. 20 No. 89 (2024) , с. 127-131
УДК 616.126.42-005.4-071

DOI:

https://doi.org/10.26724/2079-8334-2024-3-89-127-131