Moderate Chronic Ischemic Mitral Regurgitation

Int Heart J. 2019 Jul 27;60(4):796-804. doi: 10.1536/ihj.18-613. Epub 2019 Jul 12.

Abstract

The benefits of concomitant mitral valve procedure (MVP) for treating moderate chronic ischemic mitral regurgitation (IMR) during coronary artery bypass grafting (CABG) have not been clearly established. This study aimed to determine the incidence of moderate or more residual mitral regurgitation (MR) following CABG plus MVP for moderate chronic IMR, and to evaluate the impacts of concomitant MVP vs. CABG alone on clinical outcomes based on propensity-matched data.All eligible patients were entered into either the MVP group (CABG plus MVP, n = 184) or CABG group (CABG alone, n = 162). Moderate or more residual MR rate was investigated, and in-hospital and follow-up outcomes between the groups were compared after matching.Moderate or more residual MR rate was 11.4% at 1 year and 22.9% at 2 years after CABG plus MVP, respectively. Patients in the MVP group as compared with the CABG group had significantly lower moderate or more residual MR rates at various postoperative time points (all P < 0.001). Grouping was not an independent risk factor for in-hospital adverse events in multivariate logistic regression analysis. Also, grouping was a significant variable related to moderate or more residual MR rate and NYHA class III-IV at the latest follow-up in Cox regression analysis (HR = 0.391, 95% CI 0.114-0.628; HR = 0.419, 95% CI 0.233-0.819, respectively).Concomitant MVP as compared with CABG alone for treating moderate chronic IMR was associated with a reduction in moderate or more residual MR rate and an improvement in NYHA functional status, with no increase in in-hospital adverse events or follow-up death.

Keywords: In-hospital adverse events; NYHA functional status; Propensity score matching; Residual mitral regurgitation.

MeSH terms

  • Aged
  • China / epidemiology
  • Chronic Disease
  • Coronary Angiography
  • Coronary Artery Bypass / methods*
  • Echocardiography, Doppler
  • Female
  • Heart Valve Prosthesis Implantation / methods*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / surgery*
  • Mitral Valve Insufficiency / complications*
  • Mitral Valve Insufficiency / diagnosis
  • Mitral Valve Insufficiency / surgery
  • Myocardial Ischemia / complications
  • Myocardial Ischemia / diagnosis
  • Myocardial Ischemia / surgery*
  • Postoperative Complications / epidemiology
  • Risk Factors