EARLY OUTCOME OF CORONARY ARTERY BYPASS GRAFTING WITH OR WITHOUT MITRAL VALVE INTERVENTION IN PATIENTS WITH MODERATE ISCHEMIC MITRAL REGURGITATION

Abstract

Background: Ischemic mitral regurgitation is a common clinical problem of coronary artery disease, developing acutely after myocardial infarction in up to 19 % of patients. It may be chronic condition being found approximately in 3 % of patients undergoing coronary angiography, or may less commonly occur as a regional episode of ischemia.Aim of the Work: We reviewed outcomes of the most problematic subgroup of patients in terms of surgical approach—patients with moderate IMR. We evaluated the effectiveness of CABG with or without repair MVr with regard to changes in functional class, postoperative MR, LV function and short term survival benefit.Patients and Methods: Between July 2017 and June 2020, a cohort of sixty patients with ischemic heart disease associated with moderate chronic ischemic mitral regurgitation. The study was carried out in the department of cardiac surgery and other multicenters after obtaining the approval of the local ethical committee and a fully-informed written consent from each patient.Results: After our study evaluation, we found that patients who were offered the combined approach of CABG with repair, showed more improvement as to clinical and echocardiographic parameters, compared to those who were offered the CABG alone procedure. We also found that a worse preoperative LV function is the reason that leads to the persistence or progression of the IMR pathology towards severer grades in the CABG only patients.Conclusion: The efficacy of adding MVR to CABG is well demonstrated by the improvement of NYHA functional class and LVEF over the early (3 months) & late (6 months) postoperative follow-up periods.