Main description:

The International Symposium on Ischemic Mitral Incompetence was held December2-4,1988 at the Intercontinental Hotel, Berlin . It wasorganized bythe German Heart Center Berlin with the primary aim to bring together experts interested in the subject of ischemic mitral regurgitation. Our intention was to face the problems associated with diagnosis and treatment of mitral incompetence resulting from coronary artery disease. A "work-up" of the whole topic from its basic, diagnostic, and surgical aspects wasinitiated. In the first section weconcentrate on the basic anatomical and pathophysiological knowledge, as well as on experimental work. In the second section cardiologists report on inci- dence of ischemic mitral incompetence, diagnostic methods that include esophageal echocardiography, follow-up studies of medical- and surgical-treated patients. This section considers interventional therapy in acute myocardial infarc- tion, as well.
The third section includes contributions by cardiac surgeons with many years' experience in operative treatment of ischemic mitral incompetence including the decision-making criteria for non-mitral valve surgery, and for valve reconstruction or replacement.

Contents:

Functional anatomy of the myocardium and its interaction with the mitral valve apparatus.- Anatomy of the coronary arteries with respect to chronic ischemic mitral regurgitation.- Transmitral flow dynamics in the normal heart and during mitral regurgitation.- Influence of papillary muscle function on the mitral valve and left ventricular mechanics.- Predictors for mitral regurgitation in coronary artery disease.- The influence of revascularization on ischemic mitral insufficiency.- Intraoperative Doppler color flow mapping for assessment of ischemic mitral regurgitation.- Diagnostic value of transesophageal echocardiography in patients with coronary artery disease and mitral insufficiency.- Coronary angioplasty for acute mitral regurgitation due to myocardial infarction.- Mechanisms of ischemic mitral insufficiency and their surgical correction.- Technical aspects and clinical experience of mitral reconstruction in ischemic mitral incompetence.- Decision-making aspects in the surgical treatment of ischemic mitral incompetence.- Results of surgical therapy in ischemic mitral regurgitation.- Current concepts in the pathogenesis and treatment of ischemic mitral regurgitation.- Surgical treatment of ischemic mitral regurgitation by repair and replacement.- Surgical results with severe ischemic mitral regurgitation.- Surgery for acute ischemic mitral incompetence.- Closing remarks.