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Mitral annuloplasty for dilated cardiomyopathy with mitral regurgitation

Objectives This study reports survival, functional status, the change in post-operative left ventricular dimensions and function after ‘undersized mitral annuloplasty’ in patients with non-ischaemic non-valvular dilated cardiomyopathy and secondary mitral regurgitation. Patients and methods Between 2003 and 2009 10 patients (mean age 61.5 ± 14 years) with non-ischaemic, non-valvular dilated cardiomyopathy with left ventricular ejection fraction (LV EF) < 40% (mean ± SD, 30.7 ± 5.27) underwent isolated mitral repair and annuloplasty. All patients were receiving maximal drug therapy. Preoperatively 1 patient (10%) was functioning in New York Heart Association (NYHA) class II, 8 patients (80%) in class III and 1 patient (10%) in class IV. Transthoracic echocardiography was performed immediately before surgery and one year after surgery to assess valvular and ventricular function. For statistical analysis we have used paired t-tests and Wilcoxon’s rank test. Results There were no hospital deaths. Duration of intubation and ICU stay was 1.8 ± 1.3 and 3.8 ± 1.8 days, respectively. Functional class after one year was signifi cantly better than the preoperative value (from 3.00 ± 0.47 to 1.40 ± 0.52, P < 0.001). One year post-operative data showed signifi - cant improvement of LV EF (from 30.70 ± 5.27 to 46.60 ± 14.47%) and a decrease of the left ventricular diastolic dimension (LVDd) (from 59.30 ± 5.62 to 50.70 ± 6.04 mm). Conclusion Isolated undersized mitral annuloplasty in patients with non-ischaemic non-valvular dilated cardiomyopathy with associated mitral regurgitation, is a safe method with the potential of improving functional class, LV EF, and LVDd after one year.