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Mitral Valve Surgery for Dilated Cardiomyopathy with Mitral Regurgitation

Department of Cardiothoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

For reprint information contact: Masashi Toyama, MD Tel: 81 52 744 2376 Fax: 81 52 744 2383 Email: machapon{at}med.nagoya-u.ac.jp, Department of Cardiothoracic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466–8550, Japan.

Outcomes of surgery for non-ischemic non-valvular dilated cardiomyopathy with associated mitral regurgitation were assessed in 8 consecutive patients who underwent 9 mitral valve operations between 2001 and 2004. Mitral valve replacement was performed when the coaptation depth exceeded 10 mm. Two patients initially underwent mitral valvuloplasty, and 6 underwent valve replacement. One patient had valve replacement soon after valvuloplasty. Transthoracic echocardiography was performed immediately before surgery, before discharge, and during follow-up. Transesophageal echocardiography was carried out intraoperatively to assess valvular and ventricular function. Postoperative mean functional class was significantly better than the preoperative value (2.4 ± 0.7 vs. 3.3 ± 0.7), and the improvement was sustained during follow-up (2.0 ± 0.7). The ejection fraction and left ventricular end-diastolic dimension did not improve. One patient died without leaving hospital and two died during follow-up. The 2- and 4-year survival rates were 75.0% and 37.5%. Mitral valve surgery improved functional class without obvious changes in ejection fraction or left ventricular end-diastolic dimension.