Ischemic mitral valve regurgitation grade II-III: correction in patients with impaired left ventricular function undergoing simultaneous coronary revascularization.

摘要: BACKGROUND AND AIM OF THE STUDY: Mitral valve regurgitation (MVR), occurring as a result of myocardial ischemia and global left ventricular (LV) dysfunction, is predictive poor outcome. The study aim was to assess the feasibility mitral surgery concomitant with coronary artery bypass grafting (CABG) in patients ischemic MVR grade II-III impaired LV function. METHODS: Between January 1996 July 2000, 99 II III ejection fraction (LVEF) 17-30% underwent either combined CABG (group I, n = 49) or isolated II, 50). LVEF (%), end-diastolic diameter (LVEDD; mm), pressure (LVEDP; mmHg), end-systolic (LVESD; mm) respectively were 27.5+/-5, 67.7+/-7, 27.7+/-4 51.4+/-7 group I versus 27.8+/-4, 67.5+/-6, 27.5+/-5 51.2+/-6 II. In repair performed 43 (88%) replacement six (12%). RESULTS: Preoperative data analysis showed no difference between groups. Five (10%) died compared (12%) (p NS). Within months surgery, function geometry improved significantly (LVEF, p <0.001; LVEDD, 0.002; LVESD, 0.003, LVEDP, <0.001); only mild improvements seen decreased after <0.001). Cardiac index increased groups <0.001 0.03, respectively). at follow up, four undergoing died, five (11.5%) 0.007). At three years, overall survival lower than <0.009). CONCLUSION: Both MV preserving subvalvular apparatus offered acceptable outcome terms morbidity survival. Surgical correction should be taken into consideration it provides better improves