PMID: 8581190Sep 1, 1995Paper

Should a mild to moderate ischemic mitral valve regurgitation in patients with poor left ventricular function be repaired or not?

The Journal of Heart Valve Disease
J T ChristensonM Schmuziger

Abstract

In recent years coronary artery bypass grafting (CABG) has been extended to include patients with very low left ventricular ejection fractions (LVEF), also frequently with co-existing mild to moderate mitral valve regurgitation (MR). The question is, should such a MR be corrected simultaneously with a myocardial revascularization or not? Between January 1989 and November 1994, 56 patients with preoperative LVEF < or = 25% and echocardiographic evidence of co-existing MR (Grade I: 41%, II: 46%, III: 13%) underwent primary CABG. None of them had simultaneous mitral valve surgery. Twenty-nine patients (52%) had a pulmonary artery pressure (PAP) > 40 mmHg. The mean preoperative LVEF was 17.9 +/- 4.6 (10-25), mean PAP 44.2 +/- 16.1 mmHg. An average of 4.5 +/- 1.5 grafts/patient were placed and five patients had simultaneous repair of a post-infarction left ventricular aneurysm. The overall mortality was 3.6% (2/56). Transient post-operative low cardiac output syndrome occurred in 16 patients (29%). Twenty-one patients (38%) had no postoperative complications at all. The 54 hospital survivors were followed up over a mean period of 12 months (3-36 months). There was one death (eight months postoperatively) and two graft occlusions, no...Continue Reading

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