Results of Left Ventricular Reconstruction With and Without Mitral Valve Surgery

Abstract

Background: This study aims to compare the midterm outcomes of left ventricular reconstruction with those of left ventricular reconstruction plus mitral valve surgery in patients with left ventricular aneurysm due to anterior myocardial infarction and moderate mitral regurgitation.

Methods: A total of 523 patients (75 who underwent left ventricular reconstruction plus mitral valve surgery and 448 who underwent left ventricular reconstruction) with concomitant moderate mitral regurgitation were included in the study population. All-cause mortality was considered the primary endpoint. Major adverse cardiovascular and cerebrovascular events, including death, myocardial infarction, stroke, and subsequent mitral valve surgery, were considered secondary endpoints. Multivariable proportional hazards Cox regression models were used to assess the associations between groups and outcomes. In the sensitivity analysis we excluded patients who did not undergo coronary artery bypass graft and repeated the statistical analysis above.

Results: The median follow-up time among all patients was 41 months. There was no significant difference between the left ventricular reconstruction plus mitral valve surgery and the left ventricular reconstruction groups with regard to all-cause mortality (P = .208) and major adverse cardiovascular and cerebrovascular events (P = .817) after adjustment for covariates. In the sensitivity analysis there was no significant difference between the left ventricular reconstruction plus mitral valve surgery and left ventricular reconstruction groups with regard to all-cause mortality (P = .158) and major adverse cardiovascular and cerebrovascular events (P = .651) after adjustment for covariates.

Conclusions: The clinical outcomes of left ventricular reconstruction are comparable with those of left ventricular reconstruction plus mitral valve surgery in patients with left aneurysm and moderate mitral regurgitation.