Title:Timing of Surgery for Asymptomatic Primary Mitral Regurgitation:
Possible Value of Early, Serial Measurements of Left Ventricular Sphericity
Volume: 20
Issue: 2
Author(s): Alfred Stanley and Constantine Athanasuleas*
Affiliation:
- Department of Surgery, North Alabama Medical Center and Kemp-Carraway Heart Institute, Birmingham AL, USA
Keywords:
primary mitral regurgitation, left ventricular sphericity, timing of mitral valve repair, left ventricular shape, myxomatous degeneration, diastolic filling.
Abstract: Asymptomatic primary mitral regurgitation due to myxomatous degeneration of the
mitral valve leaflets may remain so for long periods, even as left ventricular function progresses
to a decompensated stage. During the early compensated stage, the ventricle’s initial response to
the volume overload is an asymmetric increase in the diastolic short axis dimension, accomplished
by a diastolic shift of the interventricular septum into the right ventricular cavity, creating
a more spherical left ventricular diastolic shape, increasing diastolic filling and stroke volume.
Early valve repair is recommended to reduce postoperative left ventricular dysfunction.
Early serial measurements of left ventricular sphericity index [LV-Si]. during the compensated
stage of mitral regurgitation might identify subtle changes in left ventricular shape and assist in
determining the optimal earliest timing for surgical intervention.
