Abstract:
OBJECTIVES:This study sought to characterize the echocardiographic features of straddling mitral valve (SMV) and to determine its surgical implications and midterm outcome in a large clinical cohort. BACKGROUND:Despite a relatively large body of literature on the postmortem anatomy of SMV, there is a paucity of information regarding its echocardiographic features, surgical implications and preoperative predictors of outcome. METHODS:A retrospective review identified 46 patients with SMV between 1982 and 1999 who underwent echocardiography and surgery and had follow-up data. A detailed review of the echocardiograms, surgical reports and all pertinent records was undertaken. RESULTS:Review of the echocardiograms revealed a widely varying anatomy among the study patients. However, four distinct groups with relatively uniform morphologic features could be distinguished on the basis of segmental analysis. Cardiac malposition associated with right ventricular hypoplasia, superior-inferior ventricles and criss-cross atrioventricular relations were common among patients with [S,D,L] (S = visceroatrial situs solitus, D = D-ventricular loop, L = L-malposition of the great arteries) (n = 6) and [S,L,D] (n = 5) segmental combinations but were rare among patients with [S,D,D] (n = 26) and [S,L,L] (n = 9) combinations. Surgical management consisted of a functional single-ventricle palliation in 38 patients (83%) and biventricular repair in 8 patients (17%). Overall mortality was 22%, but none of the seven patients who were operated on during the cohort's last five years (1994 to 1999) has died. By multivariate analysis, noncommitted ventricular septal defect was the strongest independent predictor of death (relative risk = 10.2), followed by multiple ventricular septal defects (relative risk = 4.7). CONCLUSIONS:This study demonstrates that echocardiography provides detailed noninvasive imaging of the complex anatomic features of SMV and its associated anomalies. Anatomic classification based on segmental analysis allows the distinction of four groups with more uniform morphologic features. Although a biventricular approach is feasible in selected patients, a functional univentricular palliation is indicated in those with major straddling and markedly hypoplastic ventricles.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Fraisse A,del Nido PJ,Gaudart J,Geva Tdoi
10.1016/s0735-1097(01)01441-3subject
Has Abstractpub_date
2001-09-01 00:00:00pages
819-26issue
3eissn
0735-1097issn
1558-3597pii
S0735-1097(01)01441-3journal_volume
38pub_type
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journal_title:Journal of the American College of Cardiology
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更新日期:2015-01-27 00:00:00
abstract:OBJECTIVES:We sought to identify the predictors of aneurysmal formation after surgical correction of aortic coarctation. BACKGROUND:In 9% of patients, aneurysms develop late after corrective surgery of coarctation of the aorta, with a 36% mortality rate if left untreated. However, the predictors of postsurgical aneury...
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更新日期:2002-02-20 00:00:00
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doi:10.1016/s0735-1097(86)80430-2
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doi:10.1016/s0735-1097(00)00872-x
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2014.09.071
更新日期:2014-12-30 00:00:00
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更新日期:2011-03-15 00:00:00
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更新日期:2002-11-06 00:00:00
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doi:10.1016/0735-1097(93)90239-w
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)00438-V
更新日期:1995-03-01 00:00:00
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更新日期:2010-09-07 00:00:00
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更新日期:2013-10-01 00:00:00
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更新日期:2003-01-01 00:00:00
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更新日期:2010-06-29 00:00:00
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pub_type: 杂志文章
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更新日期:1996-08-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(03)00295-x
更新日期:2003-05-21 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.jacc.2007.09.071
更新日期:2008-03-18 00:00:00
abstract::The patient with heart disease and the physician providing cardiovascular health care have experienced dramatic change since the American College of Cardiology first published its journal 25 years ago. During the decade before 1958, cardiology and cardiovascular surgery emerged as specialties. Surgery by closed techni...
journal_title:Journal of the American College of Cardiology
pub_type: 历史文章,杂志文章
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更新日期:1983-01-01 00:00:00
abstract:OBJECTIVES:This study examined the influence of left ventricular hypertrophy on the accuracy of exercise electrocardiography and echocardiography for detection of coronary artery disease. BACKGROUND:Electrocardiographic repolarization abnormalities caused by left ventricular hypertrophy compromise the diagnostic accur...
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pub_type: 临床试验,杂志文章
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更新日期:1995-11-01 00:00:00