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The Analysis of Left Ventricular Ejection Fraction after Minimally Invasive Surgery for Primary Mitral Valve Regurgitation
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  • Yukiharu Sugimura,
  • Shintaro Katahira,
  • Philipp Rellecke,
  • Hiroyuki Kamiya,
  • Jan-Philipp Minol,
  • Moritz Immohr,
  • Hug Aubin,
  • Stephan Sixt,
  • Patrick Horn,
  • Ralf Westenfeld,
  • Torsten Doenst,
  • Artur Lichtenberg,
  • Payam Akhyari
Yukiharu Sugimura
University Hospital Dusseldorf
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Shintaro Katahira
University Hospital Dusseldorf
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Philipp Rellecke
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Hiroyuki Kamiya
Asahikawa Medical University
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Jan-Philipp Minol
University Hospital Dusseldorf
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Moritz Immohr
Heinrich Heine University Düsseldorf
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Hug Aubin
University Hospital Dusseldorf
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Stephan Sixt
University Hospital Dusseldorf
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Patrick Horn
University Hospital Dusseldorf
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Ralf Westenfeld
University Hospital Dusseldorf
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Torsten Doenst
Friedrich Schiller University Jena
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Artur Lichtenberg
University Hospital Dusseldorf
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Payam Akhyari
University Hospital Dusseldorf
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Abstract

Background: Although minimally invasive mitral valve surgery (MIMVS) has become the first choice for primary mitral regurgitation (MR) in recent years, clinical evidence in this field is yet limited. The main focus of this study was the analysis of preoperative (Pre), postoperative (Post) and 1-year follow-up (Fu) data in our series of MIMVS in order to identify factors that have an impact on the left ventricular ejection fraction (LVEF) evolution after MIMVS. Methods: We reviewed the perioperative and 1-year follow-up data from 436 patients with primary MR (338 isolated MIMVS und 98 MIMVS combined with tricuspid valve repair) to analyzed patients baseline characteristics, the change of LV size, the postoperative evolution of LVEF and its factors, and the clinical outcomes. Results: The overall mean value of EF slightly decreased at 1-year follow-up (mean change of LVEF: -2.63±9.00%). A significant correlation was observed for PreEF und EF evolution, the higher PreEF the more pronounced decreased EF evolution (in all 436 patients; r= -0.54, p<0.001, in isolated MIMVS; r= -0.54, p<0.001, in combined MIMVS; r= -0.53, p<0.001). Statistically significant differences for negative EF evolution were evident in patients with mild or greater tricuspid valve regurgitation (TR) (in all patients; p<0.05, OR=1.64, in isolated MIMVS; p<0.01, OR=1.93, respectively). Overall clinical outcome in NYHA classification at 1 year was remarkably improved. Conclusions: Our results suggest an excellent clinical outcome at 1 year, although mean LVEF slightly declined over time. TR could be a predictor of worsened FuEF in patients undergoing MIMVS.

Peer review status:UNDER REVIEW

02 Sep 2020Submitted to Journal of Cardiac Surgery
03 Sep 2020Assigned to Editor
03 Sep 2020Submission Checks Completed
06 Sep 2020Reviewer(s) Assigned
23 Sep 2020Review(s) Completed, Editorial Evaluation Pending