High Prevalence of Unrecognized Chordae Tendineae Rupture in Mitral Valve Prolapse Patients Undergoing Valve Replacement Surgery

Bibliographic Details
Title: High Prevalence of Unrecognized Chordae Tendineae Rupture in Mitral Valve Prolapse Patients Undergoing Valve Replacement Surgery
Authors: Woo-In Yang, Sak Lee, Chi Young Shim, Hee Tae Yu, Jong-Won Ha, Byung Chul Chang, Geu Ru Hong, Jeonggeun Moon
Contributors: Hee Tae Yu, Jeonggeun Moon, Woo-In Yang, Chi Young Shim, Sak Lee, Byung-Chul Chang, Geu-Ru Hong, Jong-Won Ha, Shim, Chi Young, Yu, Hee Tae, Lee, Sak, Chang, Byung Chul, Ha, Jong Won, Hong, Geu Ru
Source: Canadian Journal of Cardiology. 29:1643-1648
Publisher Information: Elsevier BV, 2013.
Publication Year: 2013
Subject Terms: Delayed Diagnosis/statistics & numerical data, Adult, Male, Mitral Valve Prolapse/surgery, Delayed Diagnosis, Heart Valve Diseases, Comorbidity, Transesophageal, Mitral Valve Insufficiency/surgery, 03 medical and health sciences, 0302 clinical medicine, Heart Valve Prosthesis Implantation, Mitral Valve Insufficiency/diagnosis, Republic of Korea, Heart Valve Diseases/diagnosis, Mitral Valve Prolapse/epidemiology, Humans, Mitral Valve Insufficiency/epidemiology, Aged, Rupture, Heart Valve Diseases/epidemiology, Mitral Valve Prolapse, Mitral Valve Prolapse/diagnosis, Rupture, Spontaneous, Spontaneous, Mitral Valve Insufficiency, Middle Aged, Heart Valve Diseases/surgery, 3. Good health, Cross-Sectional Studies, Echocardiography, Chordae Tendineae, Female, Echocardiography, Transesophageal
Description: Not infrequently, chordae tendineae rupture, which was not recognized preoperatively using echocardiography, was found during mitral valve (MV) surgery in patients with severe mitral regurgitation (MR) diagnosed with MV prolapse. We evaluated the incidence and predictors of echocardiographically-unrecognized chordae tendineae rupture in patients with severe MR because of MV prolapse.We enrolled 124 patients undergoing MV surgery for severe MR because of nonrheumatic MV prolapse. Patients with MR because of infective endocarditis, ischemic heart disease, or echocardiographically-detected chordal rupture were excluded. The study sample was divided into 2 groups: surgically-proven chordae tendineae rupture (n = 51), and no chordae rupture (n = 73).Echocardiographically-unrecognized chordae tendineae rupture was found in 51 (41%) of 124 patients undergoing MV surgery because of MR. It was more common in patients with posterior or single-leaflet prolapse. Although the severity of MR was greater in patients with chordal rupture, left atrial volume index was smaller compared with those without. In a multivariate analysis, involvement of posterior leaflet (odds ratio [OR], 2.80; 95% confidence interval [CI], 1.15-6.84) or single leaflet (OR, 3.18; 95% CI, 1.07-9.45), MR severity (OR, 4.76; 95% CI, 1.96-11.59), and left atrial volume index (OR, 0.98; 95% CI, 0.96-0.99) were independently associated with chordal rupture (P < 0.05 for all).Unrecognized chordae tendineae rupture is a common unrecognized contributor to severe MR necessitating valve replacement in MV prolapse patients. Earlier recognition and more specific management might contribute to improved prognosis for such patients.
Document Type: Article
Language: English
ISSN: 0828-282X
DOI: 10.1016/j.cjca.2013.09.002
Access URL: https://pubmed.ncbi.nlm.nih.gov/24183300
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88422
https://www.onlinecjc.ca/article/S0828282X13013962/pdf
https://www.onlinecjc.ca/article/S0828-282X(13)01396-2/fulltext
https://www.sciencedirect.com/science/article/pii/S0828282X13013962
https://www.ncbi.nlm.nih.gov/pubmed/24183300
https://yonsei.pure.elsevier.com/en/publications/high-prevalence-of-unrecognized-chordae-tendineae-rupture-in-mitr
Rights: Elsevier TDM
CC BY NC ND
Accession Number: edsair.doi.dedup.....fb5d6b58c3e74d5d9e1c5eb2bf16fde3
Database: OpenAIRE
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