10-Year Results of Mitral Repair and Coronary Bypass for Ischemic Regurgitation: A Randomized Trial.

Background: The decision to treat moderate ischemic mitral regurgitation (IMR) at the time of coronary artery bypass surgery (CABG) remains controversial. We previously conducted a prospective randomized trial that showed a benefit of adding restricted annuloplasty to bypass surgery (CABG-Ring group) in terms of IMR grade, New York Heart Association classification, and left ventricle reverse remodeling. Here, we present the long-term (>10 years) follow-up data from this randomized trial.

The Role of Surgical Treatment of Severe Functional Mitral Regurgitation in Heart Failure.

Patient selection is mandatory to successful mitral valve repair in functional mitral valve regurgitation. Preoperative echo evaluation is critical to better evaluate the anatomic modification of the mitral apparatus. In light of recent randomized trials, several patients could benefit from transcatheter mitral therapy.

Mid-term results of bicuspid aortic valve repair guided by morphology and function assessment.

Objectives: Bicuspid aortic valve (BAV) is frequently associated with aortic insufficiency (AI) due to cusp disease and/or aortic root dilatation. Based on functional classification and morphology, a systematic surgical approach was used for aortic valve repair (AVr).

Methods: From 2004 to 2014, 152 consecutive patients (mean age 55 ± 7 years) with BAV underwent AVr with or without concomitant aortic root surgery.

A Comparison of 2 Mitral Annuloplasty Rings for Severe Ischemic Mitral Regurgitation: Clinical and Echocardiographic Outcomes.

Controversies regarding the choice of annuloplasty rings for treatment of ischemic mitral regurgitation still exist. Aim of the study is to compare early performance of 2 different rings in terms of rest and exercise echocardiographic parameters (transmitral gradient, systolic pulmonary artery pressure, and mitral valve area), clinical outcomes, and recurrence of mitral regurgitation. From January 2008 till December 2013, prospectively collected data of patients who underwent coronary artery bypass grafting and undersizing mitral valve annuloplasty for severe chronic ischemic mitral regurgitation at our Institution were reviewed.

Papillary muscle relocation and mitral annuloplasty in ischemic mitral valve regurgitation: midterm results.

Objectives: The surgical approach for ischemic mitral regurgitation remains unclear. Many studies are in favor of adding the subvalvular procedure to mitral annuloplasty to reduce recurrent mitral regurgitation. This study reports the clinical and echocardiographic outcomes of papillary muscle relocation combined with mitral annuloplasty.

Relocation of papillary muscles for ischemic mitral valve regurgitation: the role of three-dimensional transesophageal echocardiography.

Objective: The assessment of the mitral valve apparatus (MVA) and its modifications during ischemic mitral regurgitation (IMR) is better performed by three-dimensional (3D) transesophageal echocardiography (TEE). The aim of our study was to carry out nonrestrictive mitral annuloplasty in addition to relocation of papillary muscles (PPMs) oriented by preoperative real-time 3D TEE through the mitral valve quantification dedicated software.

Methods: Since January 2008, a total of 70 patients with severe IMR were examined both before and after mitral valve repair.

Functional annulus remodelling using a prosthetic ring in tricuspid aortic valve repair: mid-term results.

Objectives: The functional aortic valve annulus (FAVA) is a complex unit with proximal (aorto-ventricular junction) and distal (sinotubular junction) components. The aim of our study was to evaluate the impact of the total FAVA remodelling, using a prosthetic ring, on mid-term clinical and echocardiographic results after aortic valve repair.

Methods: Since February 2003, 250 patients with tricuspid aortic valve insufficiency (AI) underwent aortic valve repair.

POINT: Efficacy of adding mitral valve restrictive annuloplasty to coronary artery bypass grafting in patients with moderate ischemic mitral valve regurgitation: a randomized trial.

Objective: Surgical management of moderate chronic ischemic mitral valve regurgitation is still debated. The aim of this study was to evaluate the effect of adding mitral valve repair to coronary artery bypass grafting on clinical outcomes and left ventricular remodeling in patients who underwent coronary artery bypass grafting alone versus coronary artery bypass grafting plus mitral valve repair in a randomized trial.

Methods: Between February 2003 and May 2007, 102 patients were eligible for this study and were randomly assigned to one of 2 groups by means of card allocation: coronary artery bypass grafting plus mitral valve repair (CABG plus MVR group; 48 patients, 47%) or coronary artery bypass grafting alone (CABG group; 54 patients, 53%).

Off-pump versus on-pump myocardial revascularization in patients with ST-segment elevation myocardial infarction: a randomized trial.

Objective: Conventional cardioplegic arrest coronary artery bypass grafting after ST-segment elevation myocardial infarction is associated with high mortality and morbidity. The benefits of off-pump surgery have been suggested. This study randomly evaluated the impact of the off-pump technique on clinical results.

Beneficial effects of C1 esterase inhibitor in ST-elevation myocardial infarction in patients who underwent surgical reperfusion: a randomised double-blind study.

Background: The inflammatory cascade has been hypothesized to be an important mechanism of post-ischaemic myocardial reperfusion injury and several studies demonstrated that C1 esterase inhibitor (C1-INH) is effective in post-ischaemia myocardial protection. Therefore, we aimed to investigate prospectively in a randomised double-blind study the cardioprotective effects of C1-INH in ST segment elevation myocardial infarction (STEMI) in patients who underwent emergent reperfusion with coronary artery bypass grafting (CABG).

Methods: In this study, we enrolled 80 patients affected with STEMI who underwent emergent CABG.

Myocardial bridging in hypertrophic cardiomyopathy: a plea for surgical correction.

Myocardial bridging may be associated with an unfavorable prognosis in patients with hypertrophic cardiomyopathy. We describe a case of a young symptomatic patient with myocardial bridging associated with hypertrophic cardiomyopathy successfully treated by surgical unroofing. Such a procedure should be strongly recommended in patients with hypertrophic cardiomyopathy.