Concomitant Mitral Valve Surgery Versus No Intervention in Patients with Moderate Ischemic Mitral Regurgitation Undergoing Coronary Artery Bypass Grafting: A Propensity Score Analysis

Abstract

Objectives Ischemic mitral valve regurgitation (IMR) in patients undergoing coronary artery bypass grafting (CABG) is associated with worse long-term outcomes. This study aimed to assess the impact of mitral valve repair with CABG in patients with moderate IMR.Materials This observational study enrolled 3,215 consecutive patients from the Juntendo CABG registry with moderate IMR and multivessel coronary artery disease who underwent CABG between 2002 and 2017.Methods The CABG alone and CABG with mitral valve surgery (MVs) groups were compared. The propensity score was calculated for each patient. Long-term all-cause death, cardiac death, and major adverse cardiac and cerebrovascular events (MACCEs) were compared.Results Our database had 101 patients who underwent CABG with moderate IMR. Propensity score matching selected 40 pairs for final analysis. MVs was associated with increased risks of postoperative atrial fibrillation, blood transfusion, and longer hospitalization. Long-term outcomes, including all-cause mortality, cardiac mortality, and the incidence of MACCEs were similar.Conclusion Surgical treatment of moderate IMR combined with CABG was related to increased risk of several non-fatal short-term complications when compared to CABG alone, with similar long-term outcomes. Further studies are needed to determine the effects of MVs in patients with moderate IMR and severe coronary artery disease.