Mitral valve replacement in medically unresponsive congestive heart failure due to papillary muscle dysfunction

D. Gann, C. Colin, F. J. Hildner, P. Samet, W. Z. Yahr, C. Byrd, J. J. Greenberg

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Forty patients with a mean age of 65 years (range 44-76 years) were operated on; 30 of 40 patients (75%) had prior myocardial infarction. All had severe therapy-resistant congestive heart failure, 75% (30 of 40 patients) were symptomatic at rest, and 25% (10 of 40 patients) were symptomatic on minimal exertion. Cardiac index ranged from 1.24-2.84 L/min/m 2 (mean 1.99). Left ventricular end-diastolic pressure ranged from 3-36 Hg (mean 18). All patients had significant mitral insufficiency and contractility was reduced markedly to moderately in 63% (25 of 40 patients). Significant coronary artery disease (obstruction ≥ 75%) was present in all patients. All had mitral valve replacement, 30 had bypass surgery, and 7 left ventricular aneurysmectomy. Five died during surgery or before discharge (early mortality 12.5%). After a mean follow-up period of 16 months, another eight patients died, two with causes not related to the cardiovascular system (total mortality 32.5%). Of 20 patients with a cardiac index ≥ 1.5 L/min/m 2 and an ejection fraction ≥ 0.40, 17 survived surgery and improved postoperatively. Mitral valve replacement for this group of patients is recommended.

Original languageEnglish (US)
Pages (from-to)101-104
Number of pages4
JournalCirculation
Volume56
Issue number3 suppl. 2
StatePublished - Dec 1 1977

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Gann, D., Colin, C., Hildner, F. J., Samet, P., Yahr, W. Z., Byrd, C., & Greenberg, J. J. (1977). Mitral valve replacement in medically unresponsive congestive heart failure due to papillary muscle dysfunction. Circulation, 56(3 suppl. 2), 101-104.