Diastolic unloading and improved LV pump efficiency early after repair of the insufficient mitral valve

Ralf Günzinger, W. Heimisch, N. Augustin, D. Mazzitelli, M. Overbeck, R. Bauernschmitt, R. Lange

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: This study aimed to evaluate the acute effect of mitral valve repair (MVR) on LV hemodynamics and geometry in patients with normal ventricular function. Methods: In 10 patients with severe mitral regurgitation undergoing MVR, pressure-volume relationships were recorded before annuloplasty prior to and after hemodilution and after MVR during stable circulatory condition, using the conductance catheter technique (CC). Analyses were done off-line; volume calibration was based on data obtained after completion of valve repair (mean ± s.d.). Results: CC showed that only 61 ± 15% of left ventricular output was ejected into the systemic circulation, regurgitation volume being 39 ± 15%. MVR led to a reduction in LV stroke work index from 4.7 ± 1.8 mm Hg·l·m2 at before valve repair to 2.2 ± 1.0 mm Hg·l·m2 after surgery at unchanged cardiac index. LV diastolic filling parameters improved: LV relaxation time constant tau decreased from 52 ± 15 to 37 ± 11 ms and dP/dtmin increased from - 873 ± 231 to - 1286 ± 283 mm Hg·s -1. Conclusions: Despite cardioplegic arrest, MVR leads to acute improvement of diastolic LV function early after the operation. This may explain why valve repair has an acute positive effect in patients with impaired LV function.

Original languageEnglish
Pages (from-to)9-15
Number of pages7
JournalThoracic and Cardiovascular Surgeon
Volume53
Issue number1
DOIs
StatePublished - Feb 2005

Keywords

  • Conductance catheter
  • Left ventricular function
  • Mitral valve repair

Fingerprint

Dive into the research topics of 'Diastolic unloading and improved LV pump efficiency early after repair of the insufficient mitral valve'. Together they form a unique fingerprint.

Cite this