RF86 THE TREATMENT OF ISCHEMIC MITRAL REGURGITATION WITH THE USE OF INCOMPLETE C RING ANNULOPLASTY: LONG-TERM RESULTS

Abstract

Background and Aim: Surgical management of ischemic mitral regurgitation (IMR) is controversial, and in the setting of mitral valve repair (MVRep) the choice of the ring is still debated. We evaluate the results of MVRep with a semirigid incomplete C-ring in IMR. Methods: Between January 2006 and May 2014, 105 consecutive patients (mean age 69 ± 8 years, 75% males) underwent MVRep using an undersized C-ring during coronary artery bypass grafting to treat IMR. Mean logistic EuroSCORE was 14 ± 12%. Preoperative left ventricular ejection fraction was 43 ± 11%. Mean follow-up was 57 ± 35 months. Results: In-hospital mortality was 6.6% (7 patients). Predictor of in-hospital mortality was the duration of cardiopulmonary bypass (p < 0.05). Echocardiography performed at discharge showed a significant reduction of left ventricle end-diastolic diameter (p < 0.0001) and mitral regurgitation grade (p < 0.0001). Eight-year late death was 26% (26 patients), cardiac death 12%. Eight-year freedom from all-cause and cardiac death was 62 ± 7% and 83 ± 4%, respectively. In 7 patients (7%) recurrence of mitral regurgitation (>2 + ) was found. Freedom from recurrence of mitral regurgitation ≥ 2 and NYHA class > II were 89 ± 5% and 76 ± 9%, respectively. No patients underwent reoperation. Instable angina (p < 0.05), moderate-severe pulmonary hypertension (p < 0.0001) and left ventricle end-systolic diameter (p < 0.001) were independent predictors of long-term mortality. Conclusions: Despite the adverse prognosis of IMR, MVRep with semirigid C-ringassociated with coronary artery bypass showed satisfactory long-term survival, and low recurrence of mitral regurgitation/redo operation.