Korean J Anesthesiol.  2000 Sep;39(3):346-351. 10.4097/kjae.2000.39.3.346.

Evaluation of Left Ventricular Ejection Fraction before Mitral Valve Replacement in Patients with Chronic Mitral Regurgitation

• Lee CS
• Lim HK
• Lee HS
• Kim TJ
• Lee SK
• Shin HR
• Cha YD

• KMID: 2237599
• DOI: http://doi.org/10.4097/kjae.2000.39.3.346

Abstract

BACKGROUND: Left ventricular ejection fraction (LVEF) is considered to be an index of LV function. However, LVEF in chronic mitral regurgitation (MR) is overestimated due to a "systolic unloading effect" into the left atrium and leads to underestimation of the degree of LV dysfunction preoperatively. The purpose of this study was to evaluate the exact degree of preoperative LV dysfunction by LVEF, according to the MR grade.
METHODS
Transesophageal echocardiography (on transgastric short axis view) was performed to compare LVEF at the Pre- and Post-MVR periods, in 39 patients with chronic MR: group I, MR grade III (n = 16) and group II, MR grade IV (n = 23).
RESULTS
LVEF at Pre- and Post-MVR were 63.8 +/- 6.1% and 54.8 +/- 6.0%, respectively, and the LVEF difference between Pre- and Post-MVR was 9.0 +/- 3.5 by number (14.1 +/- 5.3% by ratio) in group I. LVEF at Pre- and Post-MVR were 68.1 +/- 7.2% and 51.7 +/- 6.0%, respectively, and the LVEF difference between Pre- and Post-MVR was 16.4 +/- 4.2 by number (24.0 +/- 5.2% by ratio) in group II.
CONCLUSIONS
For the exact evaluation of preoperative LV function in patients with chronic MR, we have to subtract 9.0 by number (14.1% by ratio) from the preoperative LVEF in MR grade III and 16.4 by number (24.0% by ratio) from the preoperative LVEF in MR grade IV.

Keyword

Heart: left ventricular ejection fraction; left ventricular function; mitral regurgitation; Surgery: mitral valve replacement

MeSH Terms

Axis, Cervical Vertebra
Echocardiography, Transesophageal
Heart Atria
Humans
Mitral Valve Insufficiency*
Mitral Valve*
Stroke Volume*