Basic principles of diagnosis and surgical treatment of ischemic mitral regurgitation

Results of surgical treatment were analyzed in 74 patients with ischemic mitral failure. Preoperative evaluation of mitral failure and its causes was carried out using echocardiography; parameters giving the quantitative characteristics of spatial correlations between valve structures (fibrous ring diameter, interpapillary intervals, annulo-papillar distance, cusp tension square, cusp cooptation) were included in the protocol allowing objective evaluation of mitral function. Results of preoperative treatment indicated postinfarction left ventricle remodeling, decreased contractile function and significant deformation of mitral valve structures. Аll patients underwent myocardial revascularization, different variants (reconstruction and prosthetics) of correction for ischemic mitral failure and surgical left ventricle remodeling. Decrease of left ventricle cavity and increase of ejection fraction were observed after the operation. Significant improvement of spatial-geometric correlation between left ventricle and mitral valve were observed among patients after mitral valvuloplasty due to decrease of tensile forces impacting the cusps.