Original Article
Clinical Outcome of Mitral Regurgitation Due to Flail Leaflet
N Engl J Med 1996; 335:1417-1423November 7, 1996
- Abstract
Background
Mitral regurgitation due to flail leaflet is difficult to manage, because it is frequently asymptomatic yet carries a high risk of left ventricular dysfunction and because the natural history of the condition is poorly defined.
Methods
We obtained clinical follow-up data through 1994–1995 in 229 patients with isolated mitral regurgitation due to flail leaflet; this condition was first diagnosed by echocardiography between 1980 and 1989.
Results
The 86 patients who were treated medically had a mortality rate significantly higher than expected (6.3 percent yearly, P = 0.016 for the comparison with the expected rate in the U.S. population according to the 1990 census). Independent determinants of mortality were an older age, the presence of symptoms, and a lower ejection fraction. Patients who were even transiently in New York Heart Association functional class III or IV had a high mortality rate (34 percent yearly), but the rate was also notable (4.1 percent yearly) among those in class I or II. At 10 years, the mean (±SE) rates of heart failure, atrial fibrillation, and death or surgery were 63±8, 30±12, and 90±3 percent, respectively. In a multivariate analysis, surgical correction of mitral regurgitation (performed in 143 patients) was associated with a reduced mortality rate (hazard ratio, 0.29; 95 percent confidence interval, 0.15 to 0.56; P<0.001).
Conclusions
When treated medically, mitral regurgitation due to flail leaflet is associated with excess mortality and high morbidity. Surgery is almost unavoidable within 10 years after the diagnosis and appears to be associated with an improved prognosis; this finding suggests that surgery should be considered early in the course of the disease.
Media in This Article
Figure 4
Incidence of Atrial Fibrillation (AF), Congestive Heart Failure (CHF), Mitral-Valve Surgery, and Surgery or Death.Figure 3
Long-Term Survival with Medical Treatment, According to the Ejection Fraction (EF).Article Activity
- Article
Mitral regurgitation is a common heart-valve disorder that is often difficult to manage. Symptoms may be absent for years,1 despite severe regurgitation. Surgical correction of mitral regurgitation can relieve symptoms,2 but when it is performed in symptomatic patients, it frequently leaves residual postoperative left ventricular dysfunction, which carries a poor prognosis.3,4 This serious complication, in conjunction with the feasibility of valve repair,5 has led to the suggestion that surgical correction be performed early in the course of mitral regurgitation.3-6 The value of this approach is unclear, however, because of the lack of data on the course of medically treated mitral regurgitation.
Previous studies of the natural history of mitral regurgitation7-16 have provided little information on morbidity and reported widely variable mortality rates. Reported survival rates at five years have ranged between 27 and 97 percent.9,10 Such conflicting data may be the result of poorly defined degrees of regurgitation,9,11,16 various selection biases,14-16 small study populations,7,11-14 and the presence of coexisting conditions that may be associated with mitral regurgitation.17 The discrepancies are difficult to reconcile, and they impede clinical decision making.
In patients with mitral regurgitation due to flail leaflet, the lesion results in uniformly high degrees of regurgitation18 and is reliably diagnosed noninvasively by echocardiography.19,20 In Western countries, flail mitral leaflet is the most frequent cause of mitral regurgitation requiring surgical correction.21,22 Nevertheless, little is known about long-term clinical outcome, and the prognosis in patients treated medically has been characterized variously as poor23 and good.24
We conducted a follow-up study of patients with mitral regurgitation due to flail leaflet, confirmed by echocardiography. The purpose of the study was to determine the long-term survival, the incidence of cardiac complications, factors that predict the outcome, and the effect of surgical treatment on the prognosis.
Methods
Patients were included in the study if they had flail mitral leaflet that had first been diagnosed with the use of two-dimensional echocardiography between January 1, 1980, and December 31, 1989, at the Mayo Clinic. Exclusion criteria were papillary-muscle rupture, previous valve surgery, and associated aortic-valve or congenital heart disease. Patients who had coronary artery disease or had undergone bypass grafting were not excluded. Base-line symptoms were defined as those occurring within one month before the diagnosis.
The 229 patients enrolled in the study were not followed only at our institution, and information on postdiagnostic events was obtained for all but 1 of the patients between March 1994 and February 1995. Cardiac events and causes of death were ascertained by contacting the patients' physicians and reviewing death certificates, coroners' reports, or autopsy records. The occurrence of arrhythmias had to be confirmed by electrocardiography. Associated medical conditions were assigned weights, and the results were summed as a modified comorbidity index.17
Echocardiographic Methods
Two-dimensional echocardiography was performed as described previously,25 and the diagnosis of flail leaflet was based on the failure of leaflet coaptation, with rapid systolic movement of the involved leaflet tip in the left atrium.19,20 The degree of mitral regurgitation was assessed semiquantitatively on a scale of 1+ to 4+.26,27 Cardiac diameters were indexed to the body-surface area. End-systolic wall stress was calculated28 with the use of noninvasive methods for estimating end-systolic pressure.29 The left ventricular ejection fraction was measured as described previously.30,31
Statistical Analysis
Continuous variables are expressed as means ±SD. The rates of mortality and other end points were estimated with the use of the Kaplan–Meier method and linearized yearly rates. To determine the outcome with medical treatment, data for patients who underwent surgical treatment were censored at the time of the surgery. To determine the effect of surgery on the outcome, data during the entire follow-up period, including the immediate postsurgical phase, were used. Survival was compared with the expected survival of age- and sex-matched white members of the U.S. population in 1990; differences in survival were determined with the one-sample log-rank test. Base-line predictors of outcome were identified with a proportional-hazards analysis. To determine the effect on survival of events occurring after the diagnosis (surgery, congestive heart failure, and atrial fibrillation), a time-dependent proportional-hazards analysis was performed within a multivariate model that included the base-line predictors of survival with and without the comorbidity index.
The effect of potential referral biases was tested by including the geographic origin of the patient and comorbidity in the multivariate analysis of survival and by repeating the analysis with data from patients not referred for surgery within the first three months and not initially in New York Heart Association (NYHA) functional class I or II. A P value of less than 0.05 was considered to indicate statistical significance.
Results
Base-Line Characteristics
The clinical characteristics of the 229 patients who met the inclusion criteria are shown in Table 1Table 1
Base-Line Characteristics of 229 Patients with Mitral Regurgitation Due to Flail Leaflet.. A total of 188 patients (82 percent) had a history of an apical cardiac murmur or cardiac symptoms for more than three months.The presumed cause of the flail leaflet was an idiopathic condition in 176 patients, infective endocarditis in 45, trauma in 5, and miscellaneous factors in 3. The posterior leaflet was involved in 187 patients, the anterior leaflet in 37, and both leaflets in 5. Base-line echocardiographic data are shown in Table 1. The degree of mitral regurgitation was reported as grade 3+ or 4+ in 168 of the 193 patients (87 percent) who were evaluated by Doppler echocardiography and in 71 of the 75 patients (95 percent) evaluated by left ventriculography.
Coronary angiography was performed in 92 patients, 28 of whom had stenosis of 70 percent or more of the diameter of at least one coronary artery.
Overall Outcome with Medical Treatment
The mortality and morbidity rates during medical treatment are shown in Table 2Table 2
Outcome at 5 and 10 Years with Medical Treatment of Mitral Regurgitation Due to Flail Leaflet.. Of the 229 patients, 45 (20 percent) died during medical treatment. The cause of death was cardiovascular in 31 patients (intractable heart failure in 13, cardiac arrest in 11, cerebral thromboembolism or hemorrhage in 3, and miscellaneous factors in 4), noncardiac in 12, and unknown in 2. Long-term survival with medical treatment was shorter than the expected survival (P = 0.016) (Figure 1Figure 1
Long-Term Survival with Medical Treatment, as Compared with Expected Survival, in 229 Patients with Mitral Regurgitation Due to Flail Leaflet.). The rate of death from cardiac causes was 21±4 percent at 5 years and 33±7 percent at 10 years.In the multivariate analysis (Table 3Table 3
Multivariate Predictors of the Outcome of Mitral Regurgitation Due to Flail Leaflet.), the base-line variables that were independently predictive of survival were age, NYHA class, and ejection fraction. Figure 2Figure 2
Long-Term Survival with Medical Treatment, According to New York Heart Association Class. and Figure 3Figure 3Long-Term Survival with Medical Treatment, According to the Ejection Fraction (EF). show the Kaplan–Meier survival curves according to NYHA class and ejection fraction, respectively.The incidence of congestive heart failure was 30±4 percent at 5 years and 63±8 percent at 10 years (Figure 4Figure 4
Incidence of Atrial Fibrillation (AF), Congestive Heart Failure (CHF), Mitral-Valve Surgery, and Surgery or Death.). Multivariate predictors of the development of congestive heart failure were age, ejection fraction, and left atrial diameter adjusted for body-surface area (Table 3). Of the 55 patients with a first episode of heart failure after the diagnosis of mitral regurgitation, 27 (49 percent) underwent surgery. Most of the remaining patients had symptomatic improvement with medical treatment, but these patients nevertheless had a higher mortality rate than those without an episode of heart failure (adjusted hazard ratio, 16.53; 95 percent confidence interval, 8.72 to 31.36; P<0.001).Of the 175 patients who were in sinus rhythm at presentation, 13 had chronic atrial fibrillation (Table 2 and Figure 4), which was independently predicted only by age. Atrial fibrillation during follow-up was not associated with excess mortality (P = 0.19).
The incidence of infective endocarditis, thromboembolic events, and major bleeding is shown in Table 2.
Mitral-Valve Surgery
Surgery was performed in 143 patients a mean of 23±32 months after the diagnosis. The remaining 86 patients were treated medically. Indications for surgery were NYHA class III or IV dyspnea in 107 patients, the physician's preference in 24, infective endocarditis in 5, angina pectoris in 4, and thromboembolism in 1; the indications could not be determined in the cases of 2 patients. The mitral valve was repaired in 95 patients and replaced in 47; in 1 patient, operated on elsewhere, the nature of the procedure was not known. Concomitant coronary-artery bypass grafting was performed in 29 patients. The operative mortality was 4 percent (6 deaths among 143 patients) overall and 2 percent (3 among 121) for the patients operated on at our institution.
The cumulative likelihood of mitral-valve surgery and of the combined end point of death or surgery is shown in Figure 4.
Effect of Symptoms on Outcome
The presence of symptoms was a major predictor of survival (Table 2 and Figure 2), but there was no difference in survival between patients in NYHA class III and those in class IV (P = 0.28) or between patients in class I and those in class II (P = 0.26).
Of the 66 patients in NYHA class III or IV at base line, 49 (74 percent) eventually underwent surgery. The other 17 patients continued to be treated medically because of the high estimated risk associated with surgery (in 6 patients) or functional improvement with treatment (in 11). Despite the frequent functional improvement, the outcome for these patients was poor (yearly mortality, 34 percent) and worse than the outcome for the patients in class I or II (hazard ratio, 8.23; 95 percent confidence interval, 4.22 to 16.05; P<0.001).
Nevertheless, the patients in NYHA class I or II had a notable annual mortality rate (4.1 percent). Of the 27 deaths that occurred during medical treatment, 19 (70 percent) were from cardiac causes, 7 of which were not preceded by class III or IV symptoms. No group was devoid of risk, with a 10-year survival of 69±10 percent among the 92 patients in class I with an ejection fraction higher than 60 percent and 78±6 percent among the 100 patients in class I or II with a comorbidity index of 0. Morbidity was high among both patients in class I and those in class II, but the likelihood of heart failure and surgery was higher among the patients in class II (Table 2).
Effect of Surgery on Survival
Among the patients who underwent surgery, survival at 5 and 10 years was 79±3 and 66±4 percent, respectively (97 and 100 percent of the expected survival, respectively; P = 0.68). Thus, when the effect of surgery on survival was considered, no excess mortality was observed.
In a multivariate proportional-hazards analysis that included the significant base-line predictors of survival, surgery performed at any time (time-dependent variable) independently and favorably influenced survival (adjusted hazard ratio, 0.29; 95 percent confidence interval, 0.15 to 0.56) (Table 3). This effect persisted even when the comorbidity index was included in the model (Table 3).
Effect of Referral Patterns on Outcome
The geographic origin of the referral (<120 miles [193 Km] from Rochester, Minn., or >120 miles) had no effect on the outcome in the multivariate analysis (P>0.20). The comorbidity rate at diagnosis (Table 1) was low, indicating that the choice of medical over surgical treatment was influenced by the cardiac status of the patients and not by coexisting conditions. The inclusion of comorbidity in the multivariate proportional-hazards models did not modify the base-line predictors of outcome.
Among the 157 patients who were not immediately referred for surgery (i.e., within 3 months after the diagnosis), the 10-year cumulative incidence of surgery and surgery or death was 73±6 and 85±4 percent, respectively; these rates are similar to the rates for the total study population. Among the 162 patients initially in NYHA class I or II, the 10-year incidence of heart failure, atrial fibrillation, and surgery or death was 61±9, 29±12, and 85±4 percent, respectively, values that are similar to the rates for the total study population.
Discussion
In this study we investigated the long-term outcome of mitral regurgitation due to flail leaflet. Among the patients treated medically there was an excess mortality directly related to the cardiac disease; a high incidence of cardiovascular complications; and an increased risk of late death among older patients, those with advanced symptoms, and those with a reduced ejection fraction at diagnosis. Death or the need for surgery is almost unavoidable within 10 years after the diagnosis. Surgical correction of mitral regurgitation appeared to improve long-term survival.
The natural history of mitral regurgitation is poorly defined, with widely disparate estimates of long-term survival. Reported survival rates of 95 percent at 20 years,9 70 percent at 10 years,16 46 and 50 percent at 5 years,11,15 and even as low as 27 percent at 5 years10 are difficult to reconcile. These disparities are probably due to small study populations7,10-12,14 and multiple selection biases8,10,11,14-16 associated with ill-defined degrees of regurgitation,7,9,11,15,16,32,33 which together may have resulted in underestimation or overestimation of the hazards of medically treated mitral regurgitation. The earlier predominance of rheumatic disease as the cause of mitral regurgitation9,11,16,32,33 also makes these data less applicable to contemporary practice, since other causes are now more common.21,22
Mitral regurgitation due to flail leaflet is uniformly associated with a large volume overload,18,34,35 whether the presentation of regurgitation is acute35 or (as it more frequently is) chronic,18,36,37 and the condition is diagnosed reliably with echocardiography.19,20 Nevertheless, different observations have been made about the clinical outcome, which has been noted to be poor23,35,38,39 or good,37,40,41 and different recommendations have been made about the need for immediate surgery23,39 or conservative treatment even for patients with hemodynamic decompensation.13,24 These inconsistent findings are based on data from small series and are not helpful in making clinical decisions, which are critically important because of the high incidence of postoperative left ventricular dysfunction in patients who undergo mitral-valve surgery at a symptomatic stage.3,4 The suggestion that earlier surgery may be appropriate,4,6 especially given the current feasibility42 and safety5 of valve repair, is debatable without firm information about the natural history of mitral regurgitation due to flail leaflet.
The present study shows that patients treated medically have excess mortality, as compared with the general population. This excess mortality is due to cardiac causes and appears to be directly related to the valvular heart disease, underscoring the severity of the disease. The 6.3 percent yearly mortality rate in our study is similar to the rate among patients with triple-vessel coronary disease.43 The incidence of related cardiac morbidity, which has not been consistently recognized,9,12 was also high in our study, with a 63 percent incidence of congestive heart failure and a 30 percent incidence of chronic atrial fibrillation at 10 years, although most of the patients were initially in NYHA class I or II. Ten years after the diagnosis, either death or surgery is almost unavoidable, even taking into account the potential bias associated with direct referrals for surgery. The observation of excess mortality and high morbidity, during an era when both medical and surgical2,3,5,6,42 treatments have been available, should raise awareness of the serious prognostic implications of the diagnosis of mitral regurgitation due to flail leaflet and should lead to a consideration of surgery based on the patient's condition at the time of the diagnosis.
Base-line predictors of death in our study were older age, higher NYHA class, and reduced ejection fraction. The high predictive power of the functional class was related in part to the poor outcome among patients in class III or IV who were not treated surgically. In the cases of these patients and those not operated on after an episode of heart failure, the attending physician was falsely reassured by rapid improvement with medical treatment. The clinical implication of this finding is that class III symptoms, even if transient, should trigger the consideration of immediate surgery, even in patients at notable operative risk.
The importance of the ejection fraction in predicting the outcome underscores the clinical significance of left ventricular dysfunction as a complication of mitral regurgitation.3,4 Despite profound changes in loading conditions,44 the ejection fraction is a powerful predictor of the outcome of mitral regurgitation.2,3,7,8 Even a mildly decreased ejection fraction (<60 percent) carries an increased risk of late mortality and heart failure and should lead to the consideration of immediate surgery.
The left atrial size, which is related to the degree of regurgitation,45,46 significantly predicted the occurrence of congestive heart failure but not of subsequent atrial fibrillation.47 If the atrial diameter is larger than 30 mm per square meter of body-surface area, surgery should be considered.
Surgical treatment of mitral regurgitation unequivocally improves symptoms and has been considered indicated primarily for patients with NYHA class III or IV symptoms.2,3 Evidence that surgery improves the prognosis for patients with a decreased ejection fraction is limited.7 Although there are no definitive data from randomized trials, the present, nonrandomized study provides evidence that surgery, whenever it is performed, is associated with improved survival independently of base-line characteristics and comorbid conditions.
Our study does not document the true natural history of mitral regurgitation due to flail leaflet — that is, the natural history of the disorder when both medical and surgical treatments are withheld. The only clinically relevant consideration is the risk incurred when surgical treatment is delayed. In our patients, the overriding reason for deferring surgical treatment was the absence of severe symptoms during medical therapy, whereas in previous series, many patients received medical treatment because of an unacceptably high operative risk.10,11,15
In asymptomatic patients it is impossible to date the onset of the flail leaflet exactly.48 Echocardiography is the only reliable method of diagnosing partial flail leaflet, however,19,20 and it provides a meaningful starting point. In our study, all 143 patients examined at surgery had flail leaflets (141 with ruptured chordae and 2 with elongated chordae).
We used echocardiographic measurements of the ejection fraction because they were available for all patients. The value of these measurements30,31 in mitral regurgitation has been verified3-5 and is confirmed by the prognostic importance of the ejection fraction in our study. Use of the echocardiographic diagnosis of flail leaflet also allowed the inclusion of a large number of asymptomatic or minimally symptomatic patients — those most commonly seen in routine clinical practice.
Since our study could not be population-based, a referral bias cannot be ruled out. However, adjustment for the geographic origin of the referrals, the presence of coexisting conditions, and the possibility of direct referrals for surgery did not affect the results, suggesting a low probability of referral bias.
Conclusions
In this study, mitral regurgitation due to flail leaflet was associated with excess mortality and high morbidity. Most patients either died or required mitral-valve surgery within 10 years after the diagnosis, underscoring the severity of the disease. A lower ejection fraction and the presence of symptoms at base line were predictors of mortality, and a larger left atrial size was a predictor of heart failure. However, even asymptomatic patients had a substantial mortality rate. Multivariate analyses suggest that surgical correction of mitral regurgitation improves survival and that surgery should therefore be considered early in the disease in patients with repairable valves and a low surgical risk.
We are indebted to Christine M. Boos for expert assistance with the data analysis.
Source Information
From the Division of Cardiovascular Diseases and Internal Medicine (L.H.L., M.E.-S., J.B.S., A.J.T., R.L.F.), the Section of Cardiovascular Surgery (H.V.S.), and the Section of Biostatistics (K.R.B.), Mayo Clinic and Mayo Foundation, Rochester, Minn.
Address reprint requests to Dr. Enriquez-Sarano at the Mayo Clinic, 200 First St. SW, Rochester, MN 55905.
- References
References
1
Selzer A ,Katayama F . Mitral regurgitation: clinical patterns, pathophysiology and natural history. Medicine (Baltimore) 1972;51:337-366
Web of Science | Medline2
Phillips HR ,Levine FH ,Carter JE , et al. Mitral valve replacement for isolated mitral regurgitation: analysis of clinical course and late postoperative left ventricular ejection fraction. Am J Cardiol 1981;48:647-654
CrossRef | Web of Science | Medline3
Enriquez-Sarano M ,Tajik AJ ,Schaff HV ,Orszulak TA ,Bailey KR ,Frye RL . Echocardiographic prediction of survival after surgical correction of organic mitral regurgitation. Circulation 1994;90:830-837
Web of Science | Medline4
Enriquez-Sarano M ,Tajik AJ ,Schaff HV , et al. Echocardiographic prediction of left ventricular function after correction of mitral regurgitation: results and clinical implications. J Am Coll Cardiol 1994;24:1536-1543
CrossRef | Web of Science | Medline5
Enriquez-Sarano M ,Schaff HV ,Orszulak TA ,Tajik AJ ,Bailey KR ,Frye RL . Valve repair improves the outcome of surgery for mitral regurgitation: a multivariate analysis. Circulation 1995;91:1022-1028
Web of Science | Medline6
Acar J ,Michel PL ,Luxereau P ,Vahanian A ,Cormier B . Indications for surgery in mitral regurgitation. Eur Heart J 1991;12:Suppl B:52-54
Web of Science | Medline7
Hochreiter C ,Niles N ,Devereux RB ,Kligfield P ,Borer JS . Mitral regurgitation: relationship of noninvasive descriptors of right and left ventricular performance to clinical and hemodynamic findings and to prognosis in medically and surgically treated patients. Circulation 1986;73:900-912
CrossRef | Web of Science | Medline8
Ramanathan KB ,Knowles J ,Connor MJ , et al. Natural history of chronic mitral insufficiency: relation of peak systolic pressure/end-systolic volume ratio to morbidity and mortality. J Am Coll Cardiol 1984;3:1412-1416
CrossRef | Web of Science | Medline9
Wilson MG ,Lim WN . The natural history of rheumatic heart disease in the third, fourth, and fifth decades of life. I. Prognosis with special reference to survivorship. Circulation 1957;16:700-712
Web of Science | Medline10
Horstkotte D ,Loogen F ,Kleikamp G ,Schulte HD ,Trampisch HJ ,Bircks W . Der Einfluβ des prothetischen Herzklappenersatzes auf den natürlichen Verlauf von isolierten Mitral- und Aortenklappenfehlern sowie Mehrklappenerkrankungen: Klinische Ergebmisse bei 783 Patienten bis zu 8 Jahren nach Implantation von Björk-Shiley-Kippscheibenprothensen. Z Kardiol 1983;72:494-503
Medline11
Munoz S ,Gallardo J ,Diaz-Gorrin JR ,Medina O . Influence of surgery on the natural history of rheumatic mitral and aortic valve disease. Am J Cardiol 1975;35:234-242
CrossRef | Web of Science | Medline12
Rosen SE ,Borer JS ,Hochreiter C , et al. Natural history of the asymptomatic/minimally symptomatic patient with severe mitral regurgitation secondary to mitral valve prolapse and normal right and left ventricular performance. Am J Cardiol 1994;74:374-380
CrossRef | Web of Science | Medline13
DePace NL ,Mintz GS ,Ren JF , et al. Natural history of the flail mitral leaflet syndrome: a serial 2-dimensional echocardiographic study. Am J Cardiol 1983;52:789-795
CrossRef | Web of Science | Medline14
Hammermeister KE ,Fisher L ,Kennedy W ,Samuels S ,Dodge HT . Prediction of late survival in patients with mitral valve disease from clinical, hemodynamic, and quantitative angiographic variables. Circulation 1978;57:341-349
Web of Science | Medline15
Delahaye JP ,Gare JP ,Viguier E ,Delahaye F ,De Gevigney G ,Milon H . Natural history of severe mitral regurgitation. Eur Heart J 1991;12:Suppl B:5-9
Web of Science | Medline16
Rapaport E . Natural history of aortic and mitral valve disease. Am J Cardiol 1975;35:221-227
CrossRef | Web of Science | Medline17
Charlson ME ,Pompei P ,Ales KL ,MacKenzie CR . A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40:373-383
CrossRef | Medline18
Pearson AC ,St Vrain J ,Mrosek D ,Labovitz AJ . Color Doppler echocardiographic evaluation of patients with a flail mitral leaflet. J Am Coll Cardiol 1990;16:232-239
CrossRef | Web of Science | Medline19
Mintz GS ,Kotler MN ,Segal BL ,Parry WR . Two-dimensional echocardiographic recognition of ruptured chordae tendineae. Circulation 1978;57:244-250
Web of Science | Medline20
Mintz GS ,Kotler MN ,Parry WR ,Segal BL . Statistical comparison of M mode and two dimensional echocardiographic diagnosis of flail mitral leaflets. Am J Cardiol 1980;45:253-259
CrossRef | Web of Science | Medline21
Olson LJ ,Subramanian R ,Ackermann DM ,Orszulak TA ,Edwards WD . Surgical pathology of the mitral valve: a study of 712 cases spanning 21 years. Mayo Clin Proc 1987;62:22-34
Web of Science | Medline22
Luxereau P ,Dorent R ,De Gevigney G ,Bruneval P ,Chomette G ,Delahaye G . Aetiology of surgically treated mitral regurgitation. Eur Heart J 1991;12:Suppl B:2-4
Web of Science | Medline23
Sanders CA ,Austen WG ,Harthorne JW ,Dinsmore RE ,Scannell JG . Diagnosis and surgical treatment of mitral regurgitation secondary to ruptured chordae tendineae. N Engl J Med 1967;276:943-949
Full Text | Web of Science | Medline24
Mitral regurgitation. In: Barlow JB. Perspectives on the mitral valve. Philadelphia: F.A. Davis, 1987:113-50.
25
Tajik AJ ,Seward JB ,Hagler DJ ,Mair DD ,Lie JT . Two-dimensional real-time ultrasonic imaging of the heart and great vessels: technique, image orientation, structure identification, and validation. Mayo Clin Proc 1978;53:271-303
Web of Science | Medline26
Abbasi AS ,Allen MW ,DeCristofaro D ,Ungar I . Detection and estimation of the degree of mitral regurgitation by range-gated pulsed Doppler echocardiography. Circulation 1980;61:143-147
Web of Science | Medline27
Helmcke F ,Nanda NC ,Hsiung MC , et al. Color Doppler assessment of mitral regurgitation with orthogonal planes. Circulation 1987;75:175-183
CrossRef | Web of Science | Medline28
Reichek N ,Wilson J ,St John Sutton M ,Plappert TA ,Goldberg S ,Hirshfeld JW . Noninvasive determination of left ventricular end-systolic stress: validation of the method and initial application. Circulation 1982;65:99-108
CrossRef | Web of Science | Medline29
Rozich JD ,Carabello BA ,Usher BW ,Kratz JM ,Bell AE ,Zile MR . Mitral valve replacement with and without chordal preservation in patients with chronic mitral regurgitation: mechanisms for differences in postoperative ejection performance. Circulation 1992;86:1718-1726
Web of Science | Medline30
Rich S ,Sheikh A ,Gallastegui J ,Kondos GT ,Mason T ,Lam W . Determination of left ventricular ejection fraction by visual estimation during real-time two-dimensional echocardiography. Am Heart J 1982;104:603-606
CrossRef | Web of Science | Medline31
Quinones MA ,Waggoner AD ,Reduto LA , et al. A new, simplified and accurate method for determining ejection fraction with two-dimensional echocardiography. Circulation 1981;64:744-753
CrossRef | Web of Science | Medline32
Ellis LB ,Ramirez A . The clinical course of patients with severe “rheumatic“ mitral insufficiency. Am Heart J 1969;78:406-418
CrossRef | Web of Science | Medline33
Jhaveri S ,Czoniczer G ,Reider RB ,Massell BF . Relatively benign “pure“ mitral regurgitation of rheumatic origin: a study of seventy-four adult patients. Circulation 1960;22:39-48
Web of Science | Medline34
Enriquez-Sarano M ,Seward JB ,Bailey KR ,Tajik AJ . Effective regurgitant orifice area: a noninvasive Doppler development of an old hemodynamic concept. J Am Coll Cardiol 1994;23:443-451
CrossRef | Web of Science | Medline35
Baxley WA ,Kennedy JW ,Feild B ,Dodge HT . Hemodynamics in ruptured chordae tendineae and chronic rheumatic mitral regurgitation. Circulation 1973;48:1288-1294
Web of Science | Medline36
Oliveira DB ,Dawkins KD ,Kay PH ,Paneth M . Chordal rupture. I. Aetiology and natural history. Br Heart J 1983;50:312-317
CrossRef | Web of Science | Medline37
Bergeron GA . Minimally symptomatic patients with ruptured chordae tendineae due to myxomatous degeneration of the mitral valve. Am J Med 1986;81:333-335
CrossRef | Web of Science | Medline38
Roberts WC ,Braunwald E ,Morrow AG . Acute severe mitral regurgitation secondary to ruptured chordae tendineae: clinical, hemodynamic, and pathologic considerations. Circulation 1966;33:58-70
Web of Science | Medline39
Sanders CA ,Scannell JG ,Harthorne JW ,Austen WG . Severe mitral regurgitation secondary to ruptured chordae tendineae. Circulation 1965;31:506-516
Web of Science | Medline40
Grenadier E ,Keidar S ,Sahn DJ , et al. Ruptured mitral chordae tendineae may be a frequent and insignificant complication in the mitral valve prolapse syndrome. Eur Heart J 1985;6:1006-1015
Web of Science | Medline41
Ren JF ,Panidis IP ,Kotler MN ,Mintz GS ,Goel I ,Ross J . Flail mitral valve syndrome: comparison with chronic mitral regurgitation of other etiologies. Am Heart J 1985;109:435-442
CrossRef | Web of Science | Medline42
Galloway AC ,Colvin SB ,Baumann FG , et al. Long-term results of mitral valve reconstruction with Carpentier techniques in 148 patients with mitral insufficiency. Circulation 1988;78:I-97
CrossRef43
Emond M ,Mock MB ,Davis KB , et al. Long-term survival of medically treated patients in the Coronary Artery Surgery Study (CASS) Registry. Circulation 1994;90:2645-2657
Web of Science | Medline44
Carabello BA . Mitral regurgitation. 1. Basic pathophysiologic principles. Mod Concepts Cardiovasc Dis 1988;57:53-6445
Gehl LG ,Mintz GS ,Kotler MN ,Segal BL . Left atrial volume overload in mitral regurgitation: a two dimensional echocardiographic study. Am J Cardiol 1982;49:33-38
CrossRef | Web of Science | Medline46
Burwash IG ,Blackmore GL ,Koilpillai CJ . Usefulness of left atrial and left ventricular chamber sizes as predictors of the severity of mitral regurgitation. Am J Cardiol 1992;70:774-779
CrossRef | Web of Science | Medline47
Vaziri SM ,Larson MG ,Benjamin EJ ,Levy D . Echocardiographic predictors of nonrheumatic atrial fibrillation: the Framingham Heart Study. Circulation 1994;89:724-730
Web of Science | Medline48
Kolibash AJ Jr ,Kilman JW ,Bush CA ,Ryan JM ,Fontana ME ,Wooley CF . Evidence for progression from mild to severe mitral regurgitation in mitral valve prolapse. Am J Cardiol 1986;58:762-767
CrossRef | Web of Science | Medline
- Citing Articles (155)
Citing Articles
1
Agnès Fournier, Mahmoud Zureik. (2012) Estimate of deaths due to valvular insufficiency attributable to the use of benfluorex in France. Pharmacoepidemiology and Drug Safetyn/a-n/a
CrossRef2
Michele De Bonis, Francesco Maisano, Giovanni La Canna, Ottavio Alfieri. (2011) Treatment and management of mitral regurgitation. Nature Reviews Cardiology
CrossRef3
Simon Maltais, Hartzell V. Schaff, Richard C. Daly, Rakesh M. Suri, Joseph A. Dearani, Thoralf M. Sundt, Maurice Enriquez-Sarano, Yan Topilsky, Soon J. Park. (2011) Mitral regurgitation surgery in patients with ischemic cardiomyopathy and ischemic mitral regurgitation: Factors that influence survival. The Journal of Thoracic and Cardiovascular Surgery 142:5, 995-1001
CrossRef4
Kargin Ramazan, Bulut Mustafa, Emiroglu Yunus, Mutlu Halil, Pala Selcuk, Akcakoyun Mustafa, Cevik Cihan, Aung Soe Moe, Özdemir Nihal. (2011) Evaluation of Left Ventricular Function by Conventional Echocardiography and Tissue Doppler Imaging in Patients with Acute and Chronic Mitral Regurgitation. Journal of Medical Ultrasound
CrossRef5
Maria Florescu, Diana Crina Ciresica Mihaela Benea, Roxana Rimbas Sisu, Gheorghe Cerin, Marco Diena, Guido Lanzzillo, Oana Aurelia Enescu, Mircea Cinteza, Dragos Vinereanu. (2011) Myocardial Systolic Velocities and Deformation Assessed by Speckle Tracking for Early Detection of Left Ventricular Dysfunction in Asymptomatic Patients with Severe Primary Mitral Regurgitation. Echocardiographyno-no
CrossRef6
J. H. Rogers, O. Franzen. (2011) Percutaneous edge-to-edge MitraClip therapy in the management of mitral regurgitation. European Heart Journal 32:19, 2350-2357
CrossRef7
H. Mutlak, M. Humpich, K. Zacharowski, R. Lehmann, D. Meininger. (2011) Herzklappenerkrankungen. Der Anaesthesist 60:9, 799-813
CrossRef8
Paul A. Grayburn, Bradley J. Roberts, Susan Aston, Azam Anwar, Robert F. Hebeler, David L. Brown, Michael J. Mack. (2011) Mechanism and Severity of Mitral Regurgitation by Transesophageal Echocardiography in Patients Referred for Percutaneous Valve Repair. The American Journal of Cardiology 108:6, 882-887
CrossRef9
Thomas H. Marwick, Paul A. Scuffham, M.G. Myriam Hunink. (2011) Selection for early surgery in asymptomatic mitral regurgitation: A Markov model. International Journal of Cardiology
CrossRef10
C. Tribouilloy, D. Rusinaru, C. Szymanski, S. Mezghani, A. Fournier, F. Levy, M. Peltier, A. Ben Ammar, D. Carmi, J.-P. Remadi, T. Caus, G. Touati. (2011) Predicting left ventricular dysfunction after valve repair for mitral regurgitation due to leaflet prolapse: additive value of left ventricular end-systolic dimension to ejection fraction. European Journal of Echocardiography 12:9, 702-710
CrossRef11
Selen Yurdakul, Yelda Tayyareci, Ozlem Yildirimturk, Kadriye Memic, Vedat Aytekin, Saide Aytekin. (2011) Subclinical Left Ventricular Dysfunction in Asymptomatic Chronic Mitral Regurgitation Patients with Normal Ejection Fraction: A Combined Tissue Doppler and Velocity Vector Imaging-Based Study. Echocardiography 28:8, 877-885
CrossRef12
Z. M. Gertz, A. Raina, S. E. Mountantonakis, E. S. Zado, D. J. Callans, F. E. Marchlinski, M. G. Keane, F. E. Silvestry. (2011) The impact of mitral regurgitation on patients undergoing catheter ablation of atrial fibrillation. Europace 13:8, 1127-1132
CrossRef13
Paul A. Grayburn, William C. Roberts. (2011) PAUL A. GRAYBURN, MD, on Percutaneous Mitral Repair With the MitraClip™ Device: A Conversation With the Editor. The American Journal of Cardiology 108:2, 277-284
CrossRef14
Jan Benes, Ludmila Kazdova, Zdenek Drahota, Josef Houstek, Dasa Medrikova, Jan Kopecky, Nikola Kovarova, Marek Vrbacky, David Sedmera, Hynek Strnad, Michal Kolar, Jiri Petrak, Oldrich Benada, Petra Skaroupkova, Ludek Cervenka, Vojtech Melenovsky. (2011) Effect of metformin therapy on cardiac function and survival in a volume-overload model of heart failure in rats. Clinical Science 121:1, 29-41
CrossRef15
Eduardo de Marchena, Amit Badiye, Giannina Robalino, Juhani Junttila, Suresh Atapattu, Mamoo Nakamura, Didier De Canniere, Tomas Salerno. (2011) Respective Prevalence of the Different Carpentier Classes of Mitral Regurgitation: A Stepping Stone for Future Therapeutic Research and Development. Journal of Cardiac Surgery 26:4, 385-392
CrossRef16
Sonal Chandra, Hicham Skali, Ron Blankstein. (2011) Novel techniques for assessment of left ventricular systolic function. Heart Failure Reviews 16:4, 327-337
CrossRef17
F. Maisano, O. Alfieri, G. La Canna. (2011) Percutaneous mitral repair with the MitraClip. Annales Françaises d'Anesthésie et de Réanimation 30, S33-S37
CrossRef18
S. E. Moustafa, M. Alharthi, M. Kansal, Y. Deng, K. Chandrasekaran, F. Mookadam. (2011) Global left atrial dysfunction and regional heterogeneity in primary chronic mitral insufficiency. European Journal of Echocardiography 12:5, 384-393
CrossRef19
S. E. Moustafa, M. Kansal, M. Alharthi, Y. Deng, K. Chandrasekaran, F. Mookadam. (2011) Prediction of incipient left ventricular dysfunction in patients with chronic primary mitral regurgitation: a velocity vector imaging study. European Journal of Echocardiography 12:4, 291-298
CrossRef20
Anna Marciniak, George R. Sutherland, Maciej Marciniak, Antonios Kourliouros, Bart Bijnens, Marjan Jahangiri. (2011) Prediction of postoperative left ventricular systolic function in patients with chronic mitral regurgitation undergoing valve surgery ??? the role of deformation imaging. European Journal of Cardio-Thoracic Surgery
CrossRef21
A. Barbieri, F. Bursi, F. Grigioni, C. Tribouilloy, J. F. Avierinos, H. I. Michelena, D. Rusinaru, C. Szymansky, A. Russo, R. Suri, M. L. Bacchi Reggiani, A. Branzi, M. G. Modena, M. Enriquez-Sarano, , C. Tribouilloy, D. Rusinaru, C. Szymanski, A. Fournier, F. Trojette, G. Touati, J. P. Remadi, F. Grigioni, A. Russo, G. Piovaccari, M. Ferlito, T. Ionico, E. Barbaresi, A. Branzi, C. Savini, S. Martin-Suarez, G. Marinelli, R. Di Bartolomeo, J. F. Avierinos, L. Tafanelli, G. Habib, F. Collard, A. Riberi, D. Metras, A. Barbieri, F. Bursi, T. Grimaldi, A. Nuzzo, M. G. Modena, M. Enriquez-Sarano, H. I. Michelena, R. Suri, M. L. Bacchi-Reggiani. (2011) Prognostic and therapeutic implications of pulmonary hypertension complicating degenerative mitral regurgitation due to flail leaflet: A Multicenter Long-term International Study. European Heart Journal 32:6, 751-759
CrossRef22
John M. Stulak, Rakesh M. Suri, Joseph A. Dearani, Harold M. Burkhart, Thoralf M. Sundt, Maurice Enriquez-Sarano, Hartzell V. Schaff. (2011) Does early surgical intervention improve left ventricular mass regression after mitral valve repair for leaflet prolapse?. The Journal of Thoracic and Cardiovascular Surgery 141:1, 122-129
CrossRef23
Reida El Oakley, Aijaz Shah. (2011) Management-Oriented Classification of Mitral Valve Regurgitation. ISRN Cardiology 2011, 1-6
CrossRef24
Ihab Asmer, Salim Adawi, Moshe Y. Flugelman, Avinoam Shiran. (2010) Spontaneous Resolution of Severe Mitral Regurgitation in a Patient with a Flail Mitral Valve. Journal of the American Society of Echocardiography 23:12, 1335.e1-1335.e4
CrossRef25
T. Obinna Onuora, Paul S. Pagel. (2010) A Duplicate Middle Scallop of the Anterior Mitral Leaflet: Benign Curiosity, Imaging Artifact, or Important Pathology?. Journal of Cardiothoracic and Vascular Anesthesia 24:6, 1010-1012
CrossRef26
E. Claver, R. Leta, S. Pujadas, A. Hidalgo, F. Carreras, G. Pons-Lladó. (2010) Evaluación del ventrículo izquierdo por ecocardiografia tridimensional. Comparación con la Cardio-RM. Radiología 52:6, 534-540
CrossRef27
Manjula Maganti, Mitesh Badiwala, Amir Sheikh, Hugh Scully, Christopher Feindel, Tirone E. David, Vivek Rao. (2010) Predictors of low cardiac output syndrome after isolated mitral valve surgery. The Journal of Thoracic and Cardiovascular Surgery 140:4, 790-796
CrossRef28
Sam Rahman, Nadia Eid, Shishir Murarka, Richard R. Heuser. (2010) Remodeling of the mitral valve using radiofrequency energy: review of a new treatment modality for mitral regurgitation. Cardiovascular Revascularization Medicine 11:4, 249-259
CrossRef29
Yan Topilsky, Rakesh Suri, Hartzell V. Schaff, Maurice Enriquez-Sarano. (2010) When to Intervene for Asymptomatic Mitral Valve Regurgitation. Seminars in Thoracic and Cardiovascular Surgery 22:3, 216-224
CrossRef30
Thierry Le Tourneau, David Messika-Zeitoun, Antonio Russo, Delphine Detaint, Yan Topilsky, Douglas W. Mahoney, Rakesh Suri, Maurice Enriquez-Sarano. (2010) Impact of Left Atrial Volume on Clinical Outcome in Organic Mitral Regurgitation. Journal of the American College of Cardiology 56:7, 570-578
CrossRef31
Robert A. Levine, Stanley Nattel. (2010) Looking Into the Left Atrial Crystal Ball. Journal of the American College of Cardiology 56:7, 579-581
CrossRef32
Foster, Elyse, . (2010) Mitral Regurgitation Due to Degenerative Mitral-Valve Disease. New England Journal of Medicine 363:2, 156-165
Full Text33
Laura Mauri, Pallav Garg, Joseph M. Massaro, Elyse Foster, Donald Glower, Paul Mehoudar, Ferolyn Powell, Jan Komtebedde, Elizabeth McDermott, Ted Feldman. (2010) The EVEREST II Trial: Design and rationale for a randomized study of the evalve mitraclip system compared with mitral valve surgery for mitral regurgitation. American Heart Journal 160:1, 23-29
CrossRef34
Héctor I. Michelena, Valentina M. Bichara, Edit Margaryan, Inga Forde, Yan Topilsky, Rakesh Suri, Maurice Enríquez-Sarano. (2010) Avances en el tratamiento de la insuficiencia mitral grave. Revista Española de Cardiología 63:7, 820-831
CrossRef35
Anders Jönsson, Magnus Settergren. (2010) MitraClip ® catheter-based mitral valve repair system. Expert Review of Medical Devices 7:4, 439-447
CrossRef36
O. Franzen, S. Baldus, V. Rudolph, S. Meyer, M. Knap, D. Koschyk, H. Treede, A. Barmeyer, J. Schofer, A. Costard-Jackle, M. Schluter, H. Reichenspurner, T. Meinertz. (2010) Acute outcomes of MitraClip therapy for mitral regurgitation in high-surgical-risk patients: emphasis on adverse valve morphology and severe left ventricular dysfunction. European Heart Journal 31:11, 1373-1381
CrossRef37
Christopher D. Steadman, Simon Ray, Leong L. Ng, Gerry P. McCann. (2010) Natriuretic Peptides in Common Valvular Heart Disease. Journal of the American College of Cardiology 55:19, 2034-2048
CrossRef38
Christelle Oliver-Dussault, Alexis Ascah, Mariannick Marcil, Jimmy Matas, Sylvie Picard, Philippe Pibarot, Yan Burelle, Christian F. Deschepper. (2010) Early predictors of cardiac decompensation in experimental volume overload. Molecular and Cellular Biochemistry 338:1-2, 271-282
CrossRef39
Ahmed M. Elwatidy. (2010) Novel Techniques in Mitral Repair. Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 5:1, 63-66
CrossRef40
E. Claver, R. Leta, S. Pujadas, A. Hidalgo, F. Carreras, G. Pons-Lladó. (2010) Evaluation of the left ventricle with three-dimensional echocardiography: Comparison with cardiac magnetic resonance. Radiología (English Edition) 52:6, 534-540
CrossRef41
Verma, Subodh, Mesana, Thierry G., . (2009) Mitral-Valve Repair for Mitral-Valve Prolapse. New England Journal of Medicine 361:23, 2261-2269
Full Text42
P. Kirchhof, J. Bax, C. Blomstrom-Lundquist, H. Calkins, A. J. Camm, R. Cappato, F. Cosio, H. Crijns, H.-C. Diener, A. Goette, C. W. Israel, K.-H. Kuck, G. Y.H. Lip, S. Nattel, R. L. Page, U. Ravens, U. Schotten, G. Steinbeck, P. Vardas, A. Waldo, K. Wegscheider, S. Willems, G. Breithardt. (2009) Early and comprehensive management of atrial fibrillation: executive summary of the proceedings from the 2nd AFNET-EHRA consensus conference 'research perspectives in AF'. European Heart Journal 30:24, 2969-2980
CrossRef43
Patrick Montant, Fabien Chenot, Annie Robert, David Vancraeynest, Agnès Pasquet, Bernard Gerber, Philippe Noirhomme, Gébrine El Khoury, Jean-Louis Vanoverschelde. (2009) Long-term survival in asymptomatic patients with severe degenerative mitral regurgitation: A propensity score–based comparison between an early surgical strategy and a conservative treatment approach. The Journal of Thoracic and Cardiovascular Surgery 138:6, 1339-1348
CrossRef44
Luc A. Pierard, Julien Magne. (2009) A New Look to an Old Measurement
Editorials published in the Journal of the American College of Cardiology reflect the views of the authors and do not necessarily represent the views of JACC or the American College of Cardiology.. Journal of the American College of Cardiology 54:21, 1969-1970
CrossRef45
Christophe Tribouilloy, Francesco Grigioni, Jean François Avierinos, Andrea Barbieri, Dan Rusinaru, Catherine Szymanski, Marinella Ferlito, Laurence Tafanelli, Francesca Bursi, Faouzi Trojette, Angelo Branzi, Gilbert Habib, Maria G. Modena, Maurice Enriquez-Sarano. (2009) Survival Implication of Left Ventricular End-Systolic Diameter in Mitral Regurgitation Due to Flail Leaflets. Journal of the American College of Cardiology 54:21, 1961-1968
CrossRef46
Joanna Chikwe, David H. Adams. (2009) State of the Art: Degenerative Mitral Valve Disease. Heart, Lung and Circulation 18:5, 319-329
CrossRef47
Krister Lindmark, Stefan Söderberg, Dag Teien, Ulf Näslund. (2009) Long-term follow-up of mitral valve regurgitation—Importance of mitral valve pathology and left ventricular function on survival. International Journal of Cardiology 137:2, 145-150
CrossRef48
Rakesh M. Suri, Hartzell V. Schaff, Steven R. Meyer, W. Clark Hargrove. (2009) Thoracoscopic Versus Open Mitral Valve Repair: A Propensity Score Analysis of Early Outcomes. The Annals of Thoracic Surgery 88:4, 1185-1190
CrossRef49
Tsung-Hsien Lin, Sheau-Fang Yang, Chaw-Chi Chiu, Ya-Ting Lee, Ho-Ming Su, Wen-Chol Voon, Wen-Ter Lai, Sheng-Hsiung Sheu. (2009) Synergistic effect of mitral expression of tissue inhibitor of metalloproteinase-2 with hypertension on the occurrence of mitral chordae tendinae rupture. Journal of Hypertension 27:10, 2079-2085
CrossRef50
Chander Mohan Mittal, Sachin Talwar, Velayoudham Devagourou, Shyam Sunder Kothari, Arkalgud Sampath Kumar. (2009) “Randomized trial comparing the use of carpentier’s ring with posterior segment annuloplasty using a C-shaped ring of teflon felt for mitral valve repair in rheumatic population”. Indian Journal of Thoracic and Cardiovascular Surgery 25:3, 114-117
CrossRef51
Rodolfo Pizarro, Oscar O. Bazzino, Pablo F. Oberti, Mariano Falconi, Federico Achilli, Anibal Arias, Juan G. Krauss, Arturo M. Cagide. (2009) Prospective Validation of the Prognostic Usefulness of Brain Natriuretic Peptide in Asymptomatic Patients With Chronic Severe Mitral Regurgitation. Journal of the American College of Cardiology 54:12, 1099-1106
CrossRef52
David S. Bach, Mazen Awais, Hitinder S. Gurm, Sarah Kohnstamm. (2009) Failure of Guideline Adherence for Intervention in Patients With Severe Mitral Regurgitation. Journal of the American College of Cardiology 54:9, 860-865
CrossRef53
Mihael Potocki, Johannes Mair, Michael Weber, Christian Hamm, Thilo Burkard, Renate Hiemetzberger, Klaus Peters, Nikolaus Jander, Thomas A. Cron, Niklaus Hess, Andreas Hoffmann, Helmut Gekeler, Christa Gohlke-Bärwolf, Peter Buser, Christian Mueller. (2009) Relation of N-Terminal Pro-B-Type Natriuretic Peptide to Symptoms, Severity, and Left Ventricular Remodeling in Patients With Organic Mitral Regurgitation. The American Journal of Cardiology 104:4, 559-564
CrossRef54
P. Kirchhof, J. Bax, C. Blomstrom-Lundquist, H. Calkins, A. J. Camm, R. Cappato, F. Cosio, H. Crijns, H.-C. Diener, A. Goette, C. W. Israel, K.-H. Kuck, G. Y.H. Lip, S. Nattel, R. L. Page, U. Ravens, U. Schotten, G. Steinbeck, P. Vardas, A. Waldo, K. Wegscheider, S. Willems, G. Breithardt. (2009) Early and comprehensive management of atrial fibrillation: Proceedings from the 2nd AFNET/EHRA consensus conference on atrial fibrillation entitled 'research perspectives in atrial fibrillation'. Europace 11:7, 860-885
CrossRef55
Emre Amirak, K.M. John Chan, Mustafa Zakkar, Prakash P. Punjabi. (2009) Current Status of Surgery for Degenerative Mitral Valve Disease. Progress in Cardiovascular Diseases 51:6, 454-459
CrossRef56
Mustafa Zakkar, Emre Amirak, K.M. John Chan, Prakash P. Punjabi. (2009) Rheumatic Mitral Valve Disease: Current Surgical Status. Progress in Cardiovascular Diseases 51:6, 478-481
CrossRef57
SHISHIR MURARKA, THOMAS WITZEL, DUANE DICKENS, PATRICIA A. TAKEDA, RICHARD R. HEUSER. (2009) Collagen Mechanics: A Rationale for Radiofrequency Energy to Treat Mitral Regurgitaton. Journal of Interventional Cardiology 22:2, 184-190
CrossRef58
Maurice Enriquez-Sarano, Cary W Akins, Alec Vahanian. (2009) Mitral regurgitation. The Lancet 373:9672, 1382-1394
CrossRef59
Mustafa I. Ahmed, David C. McGiffin, Robert A. O'Rourke, Louis J. Dell'Italia. (2009) Mitral Regurgitation. Current Problems in Cardiology 34:3, 93-136
CrossRef60
Manuel Martínez-Sellés, Miguel Angel García-Fernández, Edith Larios, Mar Moreno, Angel Pinto, José Antonio García-Robles, Esther Pérez-David, Francisco Fernández-Avilés. (2009) Etiology and short-term prognosis of severe mitral regurgitation. The International Journal of Cardiovascular Imaging 25:2, 121-126
CrossRef61
Min-Seok Kim, Yong-Jin Kim, Hyung-Kwan Kim, Joo-Yong Han, Hong-Gu Chun, Hee-Chan Kim, Dae-Won Sohn, Byung-Hee Oh, Young-Bae Park. (2009) Evaluation of left ventricular short- and long-axis function in severe mitral regurgitation using 2-dimensional strain echocardiography. American Heart Journal 157:2, 345-351
CrossRef62
James S. Gammie, Stephen T. Bartlett, Bartley P. Griffith. (2009) Small-Incision Mitral Valve Repair. Transactions of the ... Meeting of the American Surgical Association 127, 53-59
CrossRef63
Kevin M. Harris, Catherine A. Pastorius, Sue Duval, Eileen Harwood, Timothy D. Henry, Blasé A. Carabello, Alan T. Hirsch. (2009) Practice Variation Among Cardiovascular Physicians in Management of Patients With Mitral Regurgitation. The American Journal of Cardiology 103:2, 255-261
CrossRef64
Björn Plicht, Philipp Kahlert, Ranny Goldwasser, Rolf-Alexander Janosi, Peter Hunold, Raimund Erbel, Thomas Buck. (2008) Direct Quantification of Mitral Regurgitant Flow Volume by Real-Time Three-Dimensional Echocardiography Using Dealiasing of Color Doppler Flow at the Vena Contracta. Journal of the American Society of Echocardiography 21:12, 1337-1346
CrossRef65
Robert O. Bonow, Blase A. Carabello, Kanu Chatterjee, Antonio C. de Leon, David P. Faxon, Michael D. Freed, William H. Gaasch, Bruce W. Lytle, Rick A. Nishimura, Patrick T. O'Gara, Robert A. O'Rourke, Catherine M. Otto, Pravin M. Shah, Jack S. Shanewise, Rick A. Nishimura, Blase A. Carabello, David P. Faxon, Michael D. Freed, Bruce W. Lytle, Patrick T. O'Gara, Robert A. O'Rourke, Pravin M. Shah. (2008) 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease. Journal of the American College of Cardiology 52:13, e1-e142
CrossRef66
Luis M Moura, Francisco Rocha-Gonçalves, José L Zamorano, Isabel Barros, Paulo Bettencourt, Nalini Rajamannan. (2008) New cardiovascular biomarkers: clinical implications in patients with valvular heart disease. Expert Review of Cardiovascular Therapy 6:7, 945-954
CrossRef67
Thomas Buck, Björn Plicht, Philipp Kahlert, Ingmar M. Schenk, Peter Hunold, Raimund Erbel. (2008) Effect of Dynamic Flow Rate and Orifice Area on Mitral Regurgitant Stroke Volume Quantification Using the Proximal Isovelocity Surface Area Method. Journal of the American College of Cardiology 52:9, 767-778
CrossRef68
L. Conradi, H. Treede, H. Reichenspurner. (2008) Moderne Mitral- und Trikuspidalklappenchirurgie. Clinical Research in Cardiology Supplements 3:1, 41-47
CrossRef69
Philipp Kahlert, Björn Plicht, Ingmar M. Schenk, Rolf-Alexander Janosi, Raimund Erbel, Thomas Buck. (2008) Direct Assessment of Size and Shape of Noncircular Vena Contracta Area in Functional Versus Organic Mitral Regurgitation Using Real-Time Three-Dimensional Echocardiography. Journal of the American Society of Echocardiography 21:8, 912-921
CrossRef70
Blase A. Carabello. (2008) The Current Therapy for Mitral Regurgitation. Journal of the American College of Cardiology 52:5, 319-326
CrossRef71
Robert A. Levine, Ronen Durst. (2008) Mitral Valve Prolapse. JACC: Cardiovascular Imaging 1:3, 304-306
CrossRef72
Sudhir Wahi, Thomas H. Marwick. 2008. Myocardial Imaging in Valvular Heart Disease. , 223-232.
CrossRef73
Paulo Calvinho, Manuel Antunes. (2008) Current surgical management of mitral regurgitation. Expert Review of Cardiovascular Therapy 6:4, 481-490
CrossRef74
Paul A. Grayburn. (2008) Should We Operate on Asymptomatic Patients With Severe Mitral Regurgitation?. JACC: Cardiovascular Imaging 1:2, 142-144
CrossRef75
Francesco Grigioni, Christophe Tribouilloy, Jean Francois Avierinos, Andrea Barbieri, Marinella Ferlito, Faouzi Trojette, Laurence Tafanelli, Angelo Branzi, Catherine Szymanski, Gilbert Habib, Maria G. Modena, Maurice Enriquez-Sarano. (2008) Outcomes in Mitral Regurgitation Due to Flail Leaflets. JACC: Cardiovascular Imaging 1:2, 133-141
CrossRef76
Melvin D. Cheitlin, Wilbert S. Aronow. 2008. Mitral Regurgitation, Mitral Stenosis, and Mitral Annular Calcification in the Elderly. , 445-480.
CrossRef77
DOUGLAS S. LEE, RAMACHANDRAN S. VASAN. 2008. Hypertension and Valvular Heart Disease. , 233-246.
CrossRef78
Ronen Beeri, Chaim Yosefy, J. Luis Guerrero, Francesca Nesta, Suzan Abedat, Miguel Chaput, Federica del Monte, Mark D. Handschumacher, Robert Stroud, Suzanne Sullivan, Thea Pugatsch, Dan Gilon, Gus J. Vlahakes, Francis G. Spinale, Roger J. Hajjar, Robert A. Levine. (2008) Mitral Regurgitation Augments Post-Myocardial Infarction Remodeling. Journal of the American College of Cardiology 51:4, 476-486
CrossRef79
Vincent L. Sorrell, Navin C. Nanda. (2007) Role of Echocardiography in the Diagnostic Assessment and Etiology of Heart Failure in the Elderly—Opacify, Quantify, and Rectify. Heart Failure Clinics 3:4, 403-422
CrossRef80
Liam P Ryan, Alexander R Opotowski, Joseph H Gorman, Robert C Gorman. (2007) Management of mitral regurgitation in the elderly patient. Aging Health 3:5, 637-646
CrossRef81
Lissa Sugeng, Lynn Weinert, Roberto M. Lang. (2007) Real-time 3-Dimensional Color Doppler Flow of Mitral and Tricuspid Regurgitation: Feasibility and Initial Quantitative Comparison with 2-Dimensional Methods. Journal of the American Society of Echocardiography 20:9, 1050-1057
CrossRef82
Tirone E. David. (2007) Mitral Valve Repair. The Annals of Thoracic Surgery 84:3, 1066-1068
CrossRef83
Juraj Madaric, Patrick Watripont, Jozef Bartunek, Filip Casselman, Marc Vanderheyden, Frank Van Praet, William Wijns, Ann Feys, Hugo Vanermen, Bernard De Bruyne. (2007) Effect of mitral valve repair on exercise tolerance in asymptomatic patients with organic mitral regurgitation. American Heart Journal 154:1, 180-185
CrossRef84
Hartzell V. Schaff, Rakesh M. Suri, Maurice Enriquez-Sarano. (2007) Indications for Surgery in Degenerative Mitral Valve Disease. Seminars in Thoracic and Cardiovascular Surgery 19:2, 97-102
CrossRef85
(2007) Guía de práctica clínica sobre el tratamiento de las valvulopatías. Revista Española de Cardiología 60:6, 625.e1-625.e50
CrossRef86
Carlo Fucci, Giuseppe De Cicco, Ermanna Chiari, Matilde Nardi, Pompilio Faggiano, Roberto Procopio, Giuseppe Coletti, Manfredo Rambaldini, Roberto Lorusso. (2007) Edge-to-edge mitral valve repair for isolated prolapse of the anterior leaflet caused by degenerative disease. Journal of Cardiovascular Medicine 8:5, 354-358
CrossRef87
Robert A Levine, Susan A Slaugenhaupt. (2007) Molecular genetics of mitral valve prolapse. Current Opinion in Cardiology 22:3, 171-175
CrossRef88
Karine Toledano, Lawrence G. Rudski, Thao Huynh, François Béïque, John Sampalis, Jean-François Morin. (2007) Mitral regurgitation: Determinants of referral for cardiac surgery by Canadian cardiologists. Canadian Journal of Cardiology 23:3, 209-214
CrossRef89
Vincent L. Sorrell, Navin C. Nanda. (2007) Role of Echocardiography in the Diagnostic Assessment and Etiology of Heart Failure in the Elderly—Opacify, Quantify, and Rectify. Clinics in Geriatric Medicine 23:1, 31-59
CrossRef90
Antonio Maria Calafiore, Marco Contini, Angela Lorena Iacò, Michele Di Mauro, Antonio Bivona, Luca Weltert. (2007) Mitral valve repair for degenerative mitral regurgitation. Journal of Cardiovascular Medicine 8:2, 114-118
CrossRef91
Jonathan S. Grashow, Michael S. Sacks, Jun Liao, Ajit P. Yoganathan. (2006) Planar Biaxial Creep and Stress Relaxation of the Mitral Valve Anterior Leaflet. Annals of Biomedical Engineering 34:10, 1509-1518
CrossRef92
Michael S. Sacks, Yoshiharu Enomoto, Jeffrey R. Graybill, W. David Merryman, Ahmad Zeeshan, Ajit P. Yoganathan, Robert J. Levy, Robert C. Gorman, Joseph H. Gorman. (2006) In-Vivo Dynamic Deformation of the Mitral Valve Anterior Leaflet. The Annals of Thoracic Surgery 82:4, 1369-1377
CrossRef93
David H. Adams, Anelechi C. Anyanwu, Parwis B. Rahmanian, Farzan Filsoufi. (2006) Current concepts in mitral valve repair for degenerative disease. Heart Failure Reviews 11:3, 241-257
CrossRef94
Pravin M. Shah, Aidan A. Raney. (2006) Mitral Valve Repair in the Elderly: The Role of the Echocardiography/Surgery Team in Patient Outcome. The American Journal of Geriatric Cardiology 15:5, 302-305
CrossRef95
Anna Paszczuk, Susan E. Wiegers. (2006) Quantitative assessment of mitral insufficiency: Its advantages and disadvantages. Heart Failure Reviews 11:3, 205-217
CrossRef96
Robert O. Bonow, Blase A. Carabello, Kanu Chatterjee, Antonio C. de Leon, David P. Faxon, Michael D. Freed, William H. Gaasch, Bruce Whitney Lytle, Rick A. Nishimura, Patrick T. O’Gara, Robert A. O’Rourke, Catherine M. Otto, Pravin M. Shah, Jack S. Shanewise, Sidney C. Smith, Alice K. Jacobs, Cynthia D. Adams, Jeffrey L. Anderson, Elliott M. Antman, David P. Faxon, Valentin Fuster, Jonathan L. Halperin, Loren F. Hiratzka, Sharon A. Hunt, Bruce W. Lytle, Rick Nishimura, Richard L. Page, Barbara Riegel. (2006) ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease. Journal of the American College of Cardiology 48:3, e1-e148
CrossRef97
Hua Yang, William R. Davidson, Charles E. Chambers, Walter E. Pae, Benjamin Sun, David B. Campbell, Min Pu. (2006) Preoperative Pulmonary Hypertension Is Associated with Postoperative Left Ventricular Dysfunction in Chronic Organic Mitral Regurgitation: An Echocardiographic and Hemodynamic Study. Journal of the American Society of Echocardiography 19:8, 1051-1055
CrossRef98
Robert O. Bonow, Blase A. Carabello, Kanu Chatterjee, Antonio C. de Leon, David P. Faxon, Michael D. Freed, William H. Gaasch, Bruce Whitney Lytle, Rick A. Nishimura, Patrick T. O’Gara, Robert A. O’Rourke, Catherine M. Otto, Pravin M. Shah, Jack S. Shanewise, Sidney C. Smith, Alice K. Jacobs, Cynthia D. Adams, Jeffrey L. Anderson, Elliott M. Antman, David P. Faxon, Valentin Fuster, Jonathan L. Halperin, Loren F. Hiratzka, Sharon A. Hunt, Bruce W. Lytle, Rick Nishimura, Richard L. Page, Barbara Riegel. (2006) ACC/AHA 2006 Practice Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary. Journal of the American College of Cardiology 48:3, 598-675
CrossRef99
David Messika-Zeitoun, Bruce D. Johnson, Vuyisile Nkomo, Jean-François Avierinos, Thomas G. Allison, Christopher Scott, A. Jamil Tajik, Maurice Enriquez-Sarano. (2006) Cardiopulmonary Exercise Testing Determination of Functional Capacity in Mitral Regurgitation. Journal of the American College of Cardiology 47:12, 2521-2527
CrossRef100
Min Pu. (2006) The frequency, impact, and management of mitral regurgitation in patients with heart failure. Current Cardiology Reports 8:3, 226-231
CrossRef101
F. A. Flachskampf, W. G. Daniel. (2006) Mitralinsuffizienz. Der Internist 47:3, 275-286
CrossRef102
Fabio Chirillo, Loris Salvador, Claudio Cavallini. (2006) Medical and surgical treatment of chronic mitral regurgitation. Journal of Cardiovascular Medicine 7:2, 96-107
CrossRef103
Francesco Nicolini, Giampaolo Zoffoli, Giovanni Cagnoni, Andrea Agostinelli, Andrea Colli, Claudio Fragnito, Bruno Borrello, Cesare Beghi, Tiziano Gherli. (2006) Mitral valve annuloplasty and myocardial revascularization in the treatment of ischemic dilated cardiomyopathy. Heart and Vessels 21:1, 28-32
CrossRef104
H. Tschernich, R. Seitelberger, M. Hiesmayr. (2005) Untersuchung der Klappenfunktion nach Mitralklappen-Rekonstruktion. Intensivmedizin und Notfallmedizin 42:8, 683-696
CrossRef105
(2005) Surgery for Asymptomatic Mitral Regurgitation. New England Journal of Medicine 352:21, 2245-2246
Full Text106
Ko Bando, Hitoshi Kasegawa, Yukikatsu Okada, Junjiro Kobayashi, Akiko Kada, Tomoki Shimokawa, Michinori Nasu, Satoshi Nakatani, Kazuo Niwaya, Osamu Tagusari, Hiroyuki Nakajima, Mitsuhiro Hirata, Toshikatsu Yagihara, Soichiro Kitamura. (2005) Impact of preoperative and postoperative atrial fibrillation on outcome after mitral valvuloplasty for nonischemic mitral regurgitation. The Journal of Thoracic and Cardiovascular Surgery 129:5, 1032-1040
CrossRef107
Kevin D. Accola, Meredith L. Scott, Paul A. Thompson, George J. Palmer, Mark E. Sand, George Ebra. (2005) Midterm Outcomes Using the Physio Ring in Mitral Valve Reconstruction: Experience in 492 Patients. The Annals of Thoracic Surgery 79:4, 1276-1283
CrossRef108
Enriquez-Sarano, Maurice, Avierinos, Jean-François, Messika-Zeitoun, David, Detaint, Delphine, Capps, Maryann, Nkomo, Vuyisile, Scott, Christopher, Schaff, Hartzell V., Tajik, A. Jamil, . (2005) Quantitative Determinants of the Outcome of Asymptomatic Mitral Regurgitation. New England Journal of Medicine 352:9, 875-883
Full Text109
William F. Northrup. (2005) Mitral valve repair: We must do a better job. Current Cardiology Reports 7:2, 94-100
CrossRef110
Emil Hayek, Christian N Gring, Brian P Griffin. (2005) Mitral valve prolapse. The Lancet 365:9458, 507-518
CrossRef111
Jeffrey S. Borer, Katie Kupfer. (2004) Mitral regurgitation: Current treatment options and their selection. Current Treatment Options in Cardiovascular Medicine 6:6, 509-517
CrossRef112
Laila Hellgren, Per Kvidal, Lars-Gunnar Hörte, Ulla-Brith Krusemo, Elisabeth Ståhle. (2004) Survival After Mitral Valve Replacement: Rationale for Surgery Before Occurrence of Severe Symptoms. The Annals of Thoracic Surgery 78:4, 1241-1247
CrossRef113
Vincenzo DiGregorio, Kenton J. Zehr, Thomas A. Orszulak, Charles J. Mullany, Richard C. Daly, Joseph A. Dearani, Hartzell V. Schaff. (2004) Results of mitral surgery in octogenarians with isolated nonrheumatic mitral regurgitation. The Annals of Thoracic Surgery 78:3, 807-813
CrossRef114
Jeetendra B Patel, Daniel D Borgeson, Marion E Barnes, Charanjit S Rihal, Richard C Daly, Margaret M Redfield. (2004) Mitral regurgitation in patients with advanced systolic heart failure. Journal of Cardiac Failure 10:4, 285-291
CrossRef115
Blase A. Carabello. (2004) Is it ever too late to operate on the patient with valvular heart disease?. Journal of the American College of Cardiology 44:2, 376-383
CrossRef116
Harald P Kühl, Marcus Schreckenberg, Dierk Rulands, Markus Katoh, Wolfgang Schäfer, Georg Schummers, Arno Bücker, Peter Hanrath, Andreas Franke. (2004) High-resolution transthoracic real-time three-dimensional echocardiography. Journal of the American College of Cardiology 43:11, 2083-2090
CrossRef117
Antonio M Calafiore, Michele Di Mauro, Sabina Gallina, Gabriele Di Giammarco, Angela L Iacò, Giovanni Teodori, Isabella Tavarozzi. (2004) Mitral valve surgery for chronic ischemic mitral regurgitation. The Annals of Thoracic Surgery 77:6, 1989-1997
CrossRef118
Kiyotake Arikawa, Yutaka Otsuji, Hui Zhang, Bo Yu, Takeshi Uemura, Shuichi Hamasaki, Sadatoshi Biro, Akira Kisanuki, Shinichi Minagoe, Chuwa Tei. (2004) Left Ventricular Remodeling is Less While Left Atrial Remodeling is Greater in Inferior Compared to Anterior Myocardial Infarction: Importance of Ischemic Mitral Regurgitation. Journal of Echocardiography 2:2, 43-48
CrossRef119
Stephen B. Solomon. (2004) The future of interventional cardiology lies in the left atrium. Acute Cardiac Care 6:3-4, 101-106
CrossRef120
Peter S Dahlberg, Thomas A Orszulak, Charles J Mullany, Richard C Daly, Maurice Enriquez-Sarano, Hartzell V Schaff. (2003) Late outcome of mitral valve surgery for patients with coronary artery disease. The Annals of Thoracic Surgery 76:5, 1539-1548
CrossRef121
Shamik Aikat, Jannet F. Lewis. (2003) Role of echocardiography in the diagnosis and prognosis of patients with mitral regurgitation. Current Opinion in Cardiology 18:5, 334-339
CrossRef122
Takayoshi Matsumura, Eiji Ohtaki, Kaoru Tanaka, Kazuhiko Misu, Tetsuya Tobaru, Ryuta Asano, Masatoshi Nagayama, Koichi Kitahara, Jun Umemura, Tetsuya Sumiyoshi, Hitoshi Kasegawa, Saichi Hosoda. (2003) Echocardiographic prediction ofleft ventricular dysfunction aftermitral valve repair for mitral regurgitation as anindicator to decide the optimal timing of repair. Journal of the American College of Cardiology 42:3, 458-463
CrossRef123
J.-F Aviérinos. (2003) Pronostic de l’insuffisance mitrale organique chronique et indications chirurgicales. Annales de Cardiologie et d'Angéiologie 52:2, 98-103
CrossRef124
A. Marc Gillinov, Delos M. Cosgrove. (2003) Current Status of Mitral Valve Repair. The American Heart Hospital Journal 1:1, 47-54
CrossRef125
Marc D. Tischler, Atul Aggarwal. (2002) Management of mitral regurgitation due to mitral prolapse. Current Treatment Options in Cardiovascular Medicine 4:6, 521-527
CrossRef126
Francesco Grigioni, Jean-François Avierinos, Lieng H Ling, Christopher G Scott, Kent R Bailey, A.Jamil Tajik, Robert L Frye, Maurice Enriquez-Sarano. (2002) Atrial fibrillation complicating the course of degenerative mitral regurgitation. Journal of the American College of Cardiology 40:1, 84-92
CrossRef127
Dania Mohty, Maurice Enriquez-Sarano. (2002) The long-term outcome of mitral valve repair for mitral valve prolapse. Current Cardiology Reports 4:2, 104-110
CrossRef128
Iva A Smolens, Francis D Pagani, G.Michael Deeb, Richard L Prager, Seema S Sonnad, Steven F Bolling. (2001) Prophylactic mitral reconstruction for mitral regurgitation. The Annals of Thoracic Surgery 72:4, 1210-1216
CrossRef129
Otto, Catherine M., . (2001) Evaluation and Management of Chronic Mitral Regurgitation. New England Journal of Medicine 345:10, 740-746
Full Text130
Mariantonietta Cicoira, Andrea Rossi, Giorgio Golia, Giampaolo Gasparini, Maurizio Anselmi, Piero Zardini. (2001) Left Atrial Overload Can Be Used to Estimate Mitral Regurgitant Volume. Congestive Heart Failure 7:5, 259-263
CrossRef131
HELEN L. THOMSON, MAURICE ENRIQUEZ-SARANO. (2001) Echocardiographic Assessment of Mitral Regurgitation. Cardiology in Review 9:4, 210-216
CrossRef132
Helen L. Thomson, Maurice Enriquez-Sarano, A. Jamal Tajik. (2001) Timing of Surgery in Patients with Chronic, Severe Mitral Regurgitation. Cardiology in Review 9:3, 137-143
CrossRef133
Thierry Le Tourneau, Pascal de Groote, Alain Millaire, Claude Foucher, Christine Savoye, Pascal Pigny, Alain Prat, Henri Warembourg, Jean Marc Lablanche. (2000) Effect of mitral valve surgery on exercise capacity, ventricular ejection fraction and neurohormonal activation in patients with severe mitral regurgitation. Journal of the American College of Cardiology 36:7, 2263-2269
CrossRef134
Paul A. Grayburn. (2000) Southwestern Internal Medicine Conference. The American Journal of the Medical Sciences 320:3, 202-208
CrossRef135
ELIZABETH OFILI, ADEFISAYO ODUWOLE, RIGOBERT LAPA-BULA. (2000) Surgical Timing for Mitral Valve Regurgitation. Echocardiography 17:3, 285-292
CrossRef136
Craig R. Asher, William J. Stewart. (2000) Mitral regurgitation. Current Treatment Options in Cardiovascular Medicine 2:2, 105-115
CrossRef137
AYAN R. PATEL, YUKA MOCHIZUKI, JIEFEN YAO, NATESA G. PANDIAN. (2000) Mitral Regurgitation: Comprehensive Assessment by Echocardiography. Echocardiography 17:3, 275-283
CrossRef138
Lieng H. Ling, Maurice Enriquez-Sarano. (2000) Long-term outcomes of patients with flail mitral valve leaflets. Coronary Artery Disease 11:1, 3-9
CrossRef139
Michael R Phillips, Richard C Daly, Hartzell V Schaff, Joseph A Dearani, Charles J Mullany, Thomas A Orszulak. (2000) Repair of anterior leaflet mitral valve prolapse: chordal replacement versus chordal shortening. The Annals of Thoracic Surgery 69:1, 25-29
CrossRef140
Francesco Grigioni, Maurice Enriquez-Sarano, Lieng H Ling, Kent R Bailey, James B Seward, A.Jamil Tajik, Robert L Frye. (1999) Sudden death in mitral regurgitation due to flail leaflet. Journal of the American College of Cardiology 34:7, 2078-2085
CrossRef141
Carlos M.G. Duran. (1999) Surgical Techniques for the Repair of Anterior Mitral Leaflet Prolapse. Journal of Cardiac Surgery 14:6, 471-481
CrossRef142
Maurice Enriquez-Sarano, William K Freeman, Christophe M Tribouilloy, Thomas A Orszulak, Bijoy K Khandheria, James B Seward, Kent R Bailey, A.Jamil Tajik. (1999) Functional anatomy of mitral regurgitation. Journal of the American College of Cardiology 34:4, 1129-1136
CrossRef143
Maurice Enriquez-Sarano, Arsene-Joseph Basmadjian, Andrea Rossi, Kent R Bailey, James B Seward, A.Jamil Tajik. (1999) Progression of mitral regurgitation. Journal of the American College of Cardiology 34:4, 1137-1144
CrossRef144
Andrea Rossi, Giorgio Golia, Giampaolo Gasparini, Maria Antonia Prioli, Maurizio Anselmi, Piero Zardini. (1999) Left atrial filling volume can be used to reliably estimate the regurgitant volume in mitral regurgitation. Journal of the American College of Cardiology 33:1, 212-217
CrossRef145
RobertO. Bonow, Blase Carabello, AntonioC. de Leon, L.Henry Edmunds, BradleyJ. Fedderly, MichaelD. Freed, WilliamH. Gaasch, CharlesR. McKay, RickA. Nishimura, PatrickT. O’Gara, RobertA. O’Rourke, ShahbudinH. Rahimtoola, JamesL. Ritchie, MelvinD. Cheitlin, KimA. Eagle, TimothyJ. Gardner, Arthur Garson, RaymondJ. Gibbons, RobertA. O’Rourke, RichardO. Russell, ThomasJ. Ryan, SidneyC. Smith. (1998) ACC/AHA guidelines for the management of patients with valvular heart disease. Journal of the American College of Cardiology 32:5, 1486-1582
CrossRef146
Malcolm J.R Dalrymple-Hay, Mark Bryant, Richard A Jones, Stephen M Langley, Steven A Livesey, James L Monro. (1998) Degenerative mitral regurgitation: When should we operate?. The Annals of Thoracic Surgery 66:5, 1579-1583
CrossRef147
Shirley Portugese, Howard Amital, Alexander Tenenbaum, Yaron Bar-Dayan, Yair Levy, Arnon Afek, Joseph Shemesh, Yehuda Shoenfeld. (1998) Clinical characteristics of ruptured chordae tendineae in hospitalized patients: Primary tear versus infective endocarditis. Clinical Cardiology 21:11, 813-816
CrossRef148
Karanvir S. Grewal, Michael J. Malkowski, Christopher M. Kramer, Sinda Dianzumba, Nathaniel Reichek. (1998) Multiplane transesophageal echocardiographic identification of the involved scallop in patients with flail mitral valve leaflet: Intraoperative correlation. Journal of the American Society of Echocardiography 11:10, 966-971
CrossRef149
Jing Ping Sun, Xing Sheng Yang, Jian Xin Qin, Neil L Greenberg, Jianhua Zhou, Connie J Vazquez, Brian P Griffin, William J Stewart, James D Thomas. (1998) Quantification of mitral regurgitation by automated cardiac output measurement: experimental and clinical validation. Journal of the American College of Cardiology 32:4, 1074-1082
CrossRef150
Tirone E. David, Ahmad Omran, Susan Armstrong, Zhao Sun, Joan Ivanov. (1998) Long-term results of mitral valve repair for myxomatous disease with and without chordal replacement with expanded polytetrafluoroethylene sutures. The Journal of Thoracic and Cardiovascular Surgery 115:6, 1279-1286
CrossRef151
F Maisano. (1998) The edge-to-edge technique: a simplified method to correct mitral insufficiency. European Journal of Cardio-Thoracic Surgery 13:3, 240-246
CrossRef152
Karl S Dujardin, Maurice Enriquez-Sarano, Andrea Rossi, Kent R Bailey, James B Seward. (1997) Echocardiographic Assessment of Left Ventricular Remodeling: Are Left Ventricular Diameters Suitable Tools?. Journal of the American College of Cardiology 30:6, 1534-1541
CrossRef153
(1997) Mitral Regurgitation Due to Flail Leaflet. New England Journal of Medicine 336:18, 1322-1324
Full Text154
Ross, John Jr., . (1996) The Timing of Surgery for Severe Mitral Regurgitation. New England Journal of Medicine 335:19, 1456-1458
Full Text155
Carlos M.G. Duran. (1985) Surgical Techniques for the Repair of Anterior Mitral Leaflet Prolapse. Echocardiography 2:6, 471-481
CrossRef
- Letters
