The aim of our study was to analyze the impact of mechanisms of ischemic mitral regurgitation (MR) and repair technique on left ventricular remodelling postoperatively. Fifty three patients were divided into two groups according to the mechanism of MR and different surgical reconstructive technique. Echocardiographic investigations were performed preoperatively, intraoperatively, 10-14 days and 12 months after MV repair and coronary artery bypass grafting (CABG).
Results: Left ventricular geometry and function were better preserved in the group of pts with the dysfunction of the papillary muscles (group 2) and the mitral valve repair early and late postoperative results were better in this group. Left ventricular end systolic diameter index decreased from 22.9+/-3.1 mm/m(2) preoperative to 20.9+/-3.6 mm/m(2), p<0.05 and left ventricular EF increased from 34.9+/-8.4 to 41.8+/-8.1%, p<0.05 late postoperatively. Follow up revealed, that left ventricular morphometry didn't change significantly and left ventricular systolic function didn't improve in pts with isolated annular dilatation (group 1).
Conclusions: The underlying mechanism of ischemic mitral regurgitation and mitral valve repair technique has the influence on postoperative outcome. In patients with dysfunction of papillary muscles, complete reconstruction of mitral valve apparatus determined the improvement of left ventricular function late postoperatively.