Effect of off-pump coronary artery bypass grafting on mild-to-moderate ischemic mitral valve regurgitation

Abstract

Objective To evaluate the effect of off-pump coronary artery bypass grafting (OPCABG) on mild-to-moderate ischemic mitral valve regurgitation (IMR) and to explore the optimal treatment regimen. Methods From March 2011 to December 2017, 112 cases of coronary artery disease with mild-to-moderate IMR underwent isolated OPCABG. Echocardiography was performed 7 days and 6 months after surgery. Left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) and the change of mitral valve regurgitation were measured to determine whether mitral regurgitation was improved. Results No death occurred in 112 patients. Three patients underwent intra-aortic balloon pump (IABP) during operation. The mitral insufficiency of all patients was improved at 7 days and 6 months after surgery. LVEF was significantly increased 7 days after operation than that of preoperation (52.55%±3.15% vs. 48.60%±1.74%, P<0.01). LVEDD was significantly decreased 7 days after surgery than that of preoperation [(5.15±1.22)cm vs. (5.70±1.12)cm, P<0.01]. LVEF was improved 6 months after surgery than that of 7 days after operation and the difference is significant (56.90%±2.04% vs. 52.55%±3.15%, P<0.05). LVEDD was improved 6 months after surgery than that of 7 days after operation and the difference is significant [(4.87±1.08)cm vs. (5.15±1.22)cm, P<0.05]. After operation, CK-MB of 13 patients, increased in 24 hours, and decreased to normal in 48 hours. In the early postoperative period, 5 patients developed ventricular premature beats, 1 patient developed ventricular fibrillation and 9 patients developed rapid atrial fibrillation. Perioperative myocardial infarction in 1 patient and low cardiac output syndrome occurred in 1 patient, respectively. And all the patients got rid of angina after operation. Conclusions After OPCABG, blood supply of ischemic myocardial and papillary muscles can be improved, which in turn reduce the ventricle, and improve the function of left ventricular and mitral valve. Key words: Coronary artery disease; Coronary artery bypass, off-pump; Ischemic mitral valve regurgitation