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Flail mitral valve syndrome: Comparison with chronic mitral regurgitation of other etiologies
Journal article   Peer reviewed

Flail mitral valve syndrome: Comparison with chronic mitral regurgitation of other etiologies

Jian-Fang Ren, Ioannis P. Panidis, Morris N. Kotler, Gary S. Mintz, Inder Goel, John Ross and Julia C Ross
The American heart journal, v 109(3), pp 435-442
1985
PMID: 3976468

Abstract

Thirty-nine patients with symptomatic severe mitral regurgitation (MR) were studied by cardiac catheterization and two-dimensional echocardiography (2DE) prior to mitral valve replacement. A flail mitral valve was found at surgery in 23 patients (group 1); 16 patients had intact chordae tendineae (chronic MR, group 2). No difference was found between groups 1 and 2 with regard to hemodynamic findings. Left atrial volumes in end systole (LAESV) and end diastole (LAEDV) were determinod by 2DE from apical four- and two-chamber views with the use of a biplane area-length method and a light pen system. The LAESV and LAEDV measured 116 ± 66 ml and 56 ± 48 ml, respectively, in group 1, as compared with 185 ± 101 ml and 105 ± 62 ml in group 2 ( p < 0.025). Ten patients from group 1 with LAESV ≤ 100 ml (group 1A) were compared to the remaining 13 patients with LAESV > 100 ml (group 1B). Patients in group 1A had significantly smaller left ventricular volume and higher mean pulmonary wedge pressure, pulmonary artery, and left ventricular end-diastolic pressure compared to patients in groups 1B and 2 ( p < 0.05). Thus, a subset group of patients with flail mitral leaflets and smaller LAESV has hemodynamic features of acute MR, whereas the remainder with larger LAESV are indistinguishable from patients with chronic MR.

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Cardiac & Cardiovascular Systems
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