{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T18:23:54Z","timestamp":1790533434717,"version":"4.1.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9_supplement","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2005,8,30]]},"abstract":"\n \n Background\u2014<\/jats:italic>\n <\/jats:bold>\n The aim of this study was to assess the results of mitral valve (MV) repair in functional mitral regurgitation because of end-stage dilated cardiomyopathy (DCM).\n <\/jats:p>\n \n \n Methods and Results\u2014<\/jats:italic>\n <\/jats:bold>\n Seventy-seven patients with end-stage idiopathic (26 patients) or ischemic (51 patients) DCM underwent MV repair for functional mitral regurgitation (3 to 4+\/4+). Fifty-eight patients (75.3%) were in New York Heart Association class III, and 19 (24.6%) were in IV. In 23 patients (29.8%) with a coaptation depth <1 cm, an isolated undersized annuloplasty was used. In the remaining 54 (70.1%), with a coaptation depth \u22651 cm, the \u201cedge-to-edge\u201d technique was associated with the annuloplasty. In most of the cases (88.3%), a complete rigid\/semirigid ring was used. Concomitant coronary artery bypass graft was performed in 39 patients (50.6%). Hospital mortality was 3.8% (3 of 77). Actuarial survival was 90.7\u00b13.64%, and freedom from cardiac events was 81.8\u00b17.96% at 2.7 years. At a mean follow-up of 18.4\u00b19.8 months (range, 1 month to 5 years) New York Heart Association class improved from 3.4\u00b10.4 to 1.4\u00b10.6 (\n P<\/jats:italic>\n <0.0001). Mitral repair failure (recurrence of MR \u22653+\/4+) was documented in 7 patients (9%): 2 in the edge-to-edge (2 of 54, 3.7%) and 5 in the isolated annuloplasty group (5 of 23, 21.7%) (\n P<\/jats:italic>\n =0.03). Freedom from repair failure at 1.5 years was 95.0\u00b13.4% and 77\u00b112.1%, respectively (\n P<\/jats:italic>\n =0.04). The absence of the edge-to-edge was the only predictor of repair failure (\n P<\/jats:italic>\n =0.03). When residual MR was absent or mild, a reverse left ventricular remodeling was clearly documented.\n <\/jats:p>\n \n \n Conclusions\u2014<\/jats:italic>\n <\/jats:bold>\n In patients with end-stage DCM, MV repair is feasible with low hospital mortality and important symptomatic improvement. The association of the edge-to-edge technique to the undersized annuloplasty can significantly improve the durability of the repair.\n <\/jats:p>","DOI":"10.1161\/circulationaha.104.525188","type":"journal-article","created":{"date-parts":[[2021,7,3]],"date-time":"2021-07-03T03:23:18Z","timestamp":1625282598000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":87,"title":["Mitral Valve Repair for Functional Mitral Regurgitation in End-Stage Dilated Cardiomyopathy"],"prefix":"10.1161","volume":"112","author":[{"given":"Michele","family":"De Bonis","sequence":"first","affiliation":[{"name":"From the Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Lapenna","sequence":"additional","affiliation":[{"name":"From the Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"La Canna","sequence":"additional","affiliation":[{"name":"From the Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Ficarra","sequence":"additional","affiliation":[{"name":"From the Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Pagliaro","sequence":"additional","affiliation":[{"name":"From the Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Torracca","sequence":"additional","affiliation":[{"name":"From the Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Maisano","sequence":"additional","affiliation":[{"name":"From the Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ottavio","family":"Alfieri","sequence":"additional","affiliation":[{"name":"From the Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","first-page":"11","volume":"11","year":"2002","unstructured":"Tahta SA, Oury JH, Maxwell JM, Hiro SP, Duran CM. Outcome after mitral valve repair for functional ischemic mitral regurgitation. J Heart Valve Dis. 2002; 11: 11\u201319.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(00)02650-3"},{"key":"e_1_3_1_3_2","first-page":"I","volume":"100","year":"1999","unstructured":"Hung J, Handschumacher MD, Rudski L, Chow CM, Guerrero JL, Levine RA. Persistence of ischemic mitral regurgitation despite annular ring reduction: mechanistic insights from 3D echocardiography. Circulation. 1999; 100: I\u201373.","journal-title":"Circulation"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2001.120341"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(98)00828-5"},{"key":"e_1_3_1_6_2","first-page":"280","volume":"12","year":"2003","unstructured":"Kinnaird TD, Munt BI, Ignaszewski AP, Abel JG, Thompson CR. Edge-to-edge repair for functional mitral regurgitation: an echocardiographic study of the hemodynamic consequences. J Heart Valve Dis. 2003; 12: 280\u2013286.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2003.09.090"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)90745-5"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00880-4"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(02)03301-5"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0886-0440.2004.04079.x"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(98)70117-5"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000138192.65015.45"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2001.116557"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.102.12.1400"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.104.525188","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T05:09:37Z","timestamp":1715576977000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.104.525188"}},"subtitle":["Role of the \u201cEdge-to-Edge\u201d Technique"],"short-title":[],"issued":{"date-parts":[[2005,8,30]]},"references-count":15,"journal-issue":{"issue":"9_supplement","published-print":{"date-parts":[[2005,8,30]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.104.525188"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.104.525188","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,8,30]]},"assertion":[{"value":"2005-08-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}