{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:51:05Z","timestamp":1767707465474,"version":"3.45.0"},"reference-count":14,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T00:00:00Z","timestamp":1562112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Cardiac Surgery"],"published-print":{"date-parts":[[2019,10]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n Degenerative mitral valve (MV) regurgitation (MR) is associated with left ventricular (LV) dilatation. Surgical treatment of MR has been shown to favorably affect LV remodeling. We prospectively compared the long\u2010term echocardiographic outcomes of LV remodeling following mini\u2010mitral repair for simple versus complex MV disease.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We prospectively followed up 203 consecutive patients who underwent mini\u2010MV repair for severe degenerative MR over a 9\u2010year period. Simple disease (n\u2009=\u2009122 patients: posterior leaflet prolapse) was compared to complex disease (n\u2009=\u200981 patients: anterior, bilateral or commissural prolapse). Baseline demographics were similar between simple and complex groups (age: 63\u2009\u00b1\u200913 years vs 60\u2009\u00b1\u200915 years;\n p<\/jats:italic>\n \u2009=\u2009.2; sex: 71% male vs 72% male,\n p<\/jats:italic>\n \u2009=\u20091; preoperative MR grade\u2009\u2265\u20093+: 100%; n\u2009=\u2009122; vs 100%; n\u2009=\u200981;\n p<\/jats:italic>\n \u2009=\u20091), respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Preoperative left ventricular ejection fraction (LVEF) was significantly lower in the complex group as compared to the simple group (57.2% simple vs 56.0% complex;\n p<\/jats:italic>\n \u2009=\u2009.04). Preoperative LV end\u2010systolic diameter (LVESD: 35\u2009mm simple vs 36\u2009mm complex,\n p<\/jats:italic>\n \u2009<\u2009.05) and LV end\u2010diastolic diameter (LVEDD: 50\u2009mm simple vs 51\u2009mm complex;\n p<\/jats:italic>\n \u2009<\u2009.05), as well as LV mass index (99.5\u2009g\/m\n 2<\/jats:sup>\n vs 102.4\u2009g\/m\n 2<\/jats:sup>\n ;\n p<\/jats:italic>\n \u2009=\u2009.06) were larger in the complex group. Despite different baseline characteristics of LV function and geometry, both groups had similar remodeling of LV after MV repair.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Patients with complex MV disease are referred late for surgical repair, causing LV function and dimensions to never fully recover. This suggests that earlier referral (before LV changes and potentially before symptoms) may be the preferred approach in those with complex disease.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jocs.14146","type":"journal-article","created":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T13:59:22Z","timestamp":1562162362000},"page":"913-918","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Left ventricular remodeling after mini\u2010mitral repair\u2014does the complexity of mitral disease matter?"],"prefix":"10.1155","volume":"34","author":[{"given":"Fadi","family":"Hage","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery London Health Sciences Centre London Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9575-5566","authenticated-orcid":false,"given":"Ali","family":"Hage","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery London Health Sciences Centre London Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usha","family":"Manian","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Western University, London Health Sciences Centre London Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Tzemos","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Western University, London Health Sciences Centre London Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael W. A.","family":"Chu","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery London Health Sciences Centre London Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,3]]},"reference":[{"key":"e_1_2_8_1_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.03.041"},{"key":"e_1_2_8_1_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.11.030"},{"key":"e_1_2_8_1_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.10.026"},{"key":"e_1_2_8_1_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.08.068"},{"key":"e_1_2_8_1_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.04.044"},{"key":"e_1_2_8_1_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/14779072.2017.1266936"},{"key":"e_1_2_8_1_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.optechstcvs.2015.10.003"},{"key":"e_1_2_8_1_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2018.02.102"},{"key":"e_1_2_8_1_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.05.045"},{"key":"e_1_2_8_1_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.90.2.830"},{"key":"e_1_2_8_1_12_1","first-page":"460","article-title":"Mortality and morbidity after mitral valve repair: the importance of left ventricular dysfunction","volume":"4","author":"Lee EM","year":"1995","journal-title":"J Heart Valve Dis"},{"key":"e_1_2_8_1_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2005.06.046"},{"key":"e_1_2_8_1_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.06.047"},{"key":"e_1_2_8_1_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.599175"}],"container-title":["Journal of Cardiac Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocs.14146","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocs.14146","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocs.14146","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T08:30:18Z","timestamp":1763454618000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocs.14146"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,3]]},"references-count":14,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1111\/jocs.14146"],"URL":"https:\/\/doi.org\/10.1111\/jocs.14146","archive":["Portico"],"relation":{},"ISSN":["0886-0440"],"issn-type":[{"type":"print","value":"0886-0440"}],"subject":[],"published":{"date-parts":[[2019,7,3]]},"assertion":[{"value":"2019-07-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}