OBJECTIVE: @entity384 with functional @entity339 carries a poor prognosis. Mitral valve surgery with implantation of a cardiac support device can treat @entity339 and promote left ventricular reverse remodeling. This observational study evaluates clinical and echocardiographic outcomes of an individualized medico-surgical approach, focusing on @entity339 recurrence and left ventricular reverse remodeling. METHODS: Sixty-nine consecutive @entity1 with @entity712 (New York Heart Association class III/IV) with functional @entity339 (grade 3+/4+) and left ventricular remodeling (end-diastolic volume 227    73 mL, ejection fraction 26%    8%) underwent restrictive mitral annuloplasty (median ring size 26), with (n = 41) or without (n = 28) a cardiac support device and optimal postoperative medical treatment. @entity1 were clinically and echocardiographically evaluated at up to 3.1 years' median follow-up. RESULTS: Early mortality was 5.8%. Actuarial survival at 1, 2, and 5 years was 86%    4%, 79%    5%, and 63%    7%. New York Heart Association class improved from 3.1    0.4 to 2.0    0.5 (P < .01). Cardiac support device implantation in addition to mitral valve surgery, applied in @entity1 with more advanced left ventricular remodeling, resulted in similar clinical outcome, greater left ventricular end-diastolic volume decrease (33% vs 18%; P = .007), and in a trend toward less recurrent @entity339 of grade 2+ or more (actuarial freedom at 3 years 89%    8% vs 63%    11%; P = .067). CONCLUSIONS: An individualized medico-surgical approach to @entity296 combining restrictive mitral annuloplasty, cardiac support device implantation, and optimal medical management leads to favorable survival and improved functional status, low incidence of significant recurrent @entity339 , and sustained left ventricular reverse remodeling.

Cardiac support device, restrictive mitral valve annuloplasty, and optimized medical treatment: a multimodality approach to XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity296 :: ('MESH:D009202', 'Disease') :: ['nonischemic cardiomyopathy'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity339 :: ('MESH:D008944', 'Disease') :: ['mitral regurgitation'] @entity384 :: ('MESH:D002311', 'Disease') :: ['Nonischemic dilated cardiomyopathy']
@entity296 :: (MESH:D009202,Disease) :: ['nonischemic cardiomyopathy']
