Predictors of Improvement of Unrepaired Moderate Ischemic Mitral Regurgitation in Patients Undergoing Elective Isolated Coronary Artery Bypass Graft Surgery
- 13 October 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 120 (15), 1474-1481
- https://doi.org/10.1161/circulationaha.108.842104
Abstract
Background— The persistence of moderate ischemic mitral regurgitation (IMR) after isolated coronary artery bypass graft surgery is an important independent predictor of long-term mortality. The aim of the present study was to identify predictors of postoperative improvement in moderate IMR in patients with ischemic heart disease undergoing elective isolated coronary artery bypass graft surgery. Methods and Results— The study population consisted of 135 patients with ischemic heart disease (age, 65±9 years; 81% male) and moderate IMR undergoing isolated coronary artery bypass graft surgery. Fourteen patients died before the 12-month follow-up echocardiography and were excluded. At the 12-month follow-up, 57 patients showed no or mild IMR (improvement group), whereas 64 patients failed to improve (failure group). Before coronary artery bypass graft surgery, the improvement group had significantly more viable myocardium and less dyssynchrony between papillary muscles than the failure group ( P P P P Conclusion— Reliable improvement in moderate IMR by isolated coronary artery bypass graft surgery was observed only in patients with concomitant presence of viable myocardium and absence of dyssynchrony between papillary muscles.Keywords
This publication has 32 references indexed in Scilit:
- 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart DiseaseCirculation, 2008
- Mild or Moderate Ischemic Mitral Regurgitation in Patients Undergoing Off-Pump Coronary Artery Bypass GraftingJournal of Cardiac Surgery, 2007
- Severe Left Ventricular Dyssynchrony Is Associated With Poor Prognosis in Patients With Moderate Systolic Heart Failure Undergoing Coronary Artery Bypass GraftingJournal of the American College of Cardiology, 2007
- Impact of Mitral Valve Annuloplasty Combined With Revascularization in Patients With Functional Ischemic Mitral RegurgitationJournal of the American College of Cardiology, 2007
- Guidelines on the management of valvular heart disease: replyEuropean Heart Journal, 2007
- Mitral Valve Repair Versus Revascularization Alone in the Treatment of Ischemic Mitral RegurgitationCirculation, 2006
- Long-Term Survival After Surgical Revascularization for Moderate Ischemic Mitral RegurgitationThe Annals of Thoracic Surgery, 2005
- Impact of mitral valve annuloplasty on mortality risk in patients with mitral regurgitation and left ventricular systolic dysfunctionJournal of the American College of Cardiology, 2005
- Survival After Coronary Revascularization, With and Without Mitral Valve Surgery, in Patients With Ischemic Mitral RegurgitationCirculation, 2003
- Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and doppler echocardiographyJournal of the American Society of Echocardiography, 2003