Objective In severe ischemic mitral regurgitation (IMR), there
is benefit evidence for mitral valve repair with coronary artery
bypass grafting (CABG). However, there is still a debate
around combined repair and CABG for moderate IMR. We
evaluate our results over 4-year follow-up for patients with
moderate IMR who underwent isolated CABG and combined
with mitral ring annuloplasty.
Methods We retrospectively studied patients with moderate
IMR; 69 patients underwent CABG alone group (A), and 77
patients underwent CABG with mitral valve ring annuloplasty
group (B). New York Heart Association functional class
(NYHA class), mitral regurgitation (MR) grade, and left ventricle
(LV) dimension and ejection fraction (EF) were assessed
preoperatively, 1 and 4 years postoperatively.
Results The mortality rate was 2.9% in group (A) and 1.8% in
group (B) p = 0.1593. Improvement in NYHA class, MR, and
LVEF % were significant in both groups at 1 year with no significant
changes at 4 years. However, group (B) showed
significant improvement in LVEF % than group (A) at 4 years
(47.5 ± 7.3 vs 44 ± 1.7, p 0.0001). It showed improvement in
NYHA class at 1 and 4 years (1.5 ± 0.4 vs 2.1 ± 0.2) and (1 ± 0.2
vs 1.5 ± 0.5) p 0.0001, respectively. After 4 years, group (A)
showed deterioration of MR degree in 4.3% of patients.
Conclusion We strongly advise to add mitral valve ring
annuloplasty with CABG for patients with moderate IMR. |
