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Abstract
Preoperative left ventricular (LV) dysfunction is a risk factor for postoperative worsening of LV function and decreased long term survival in patients with severe mitral regurgitation (MR). Compared with patients who undergo surgery before the development of LV dysfunction, patients with LV impairment experience a greater fall in ejection fraction (EF) after surgery, an increased incidence of heart failure, and a higher mortality 2. Several parameters have been proposed for patients with chronic MR to assess LV function. Ejection fraction (EF%) is the most commonly used. However, the assessment of EF depends on afterload and EF remains higher than normal during the compensated phase of chronic MR. When LV dysfunction develops, EF may fall but remains within normal limits because of a reduced afterload. Other more early myocardial dysfunction in chronic MR: end systolic volume corrected for body surface area and end systolic LV cavity dimension. However despite serial preoperative testing with these parameters, postoperative LV dysfunction remains poorly predictable. LV cavity dimensions and EF are indirect measurements of the intrinsic myocardial function and both reflect the hemodynamic consequences of MR 1.