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Coronary revascularization alone or with mitral valve repair: outcomes in patients with moderate ischemic mitral regurgitation.
Tex Heart Inst J 2009; 36(5):416-24TH

Abstract

We sought to evaluate retrospectively the outcomes of patients at our hospital who had moderate ischemic mitral regurgitation and who underwent coronary artery bypass grafting (CABG) alone or with concomitant mitral valve repair (CABG+MVr).A total of 83 patients had a reduced left ventricular ejection fraction and moderate mitral regurgitation: 28 patients underwent CABG+MVr, and 55 underwent CABG alone. Changes in mitral regurgitation, functional class, and left ventricular ejection fraction were compared in both groups.The mean follow-up was 5.1 +/- 3.6 years (range, 0.1-15.1 yr). Reduction of 2 mitral-regurgitation grades was found in 85% of CABG+MVr patients versus 14% of CABG-only patients (P < 0.0001) at 1 year, and in 56% versus 14% at 5 years, respectively (P = 0.1), as well as improvements in left ventricular ejection fraction and functional class. One- and 5-year survival rates were similar in the CABG+MVr and CABG-only groups: 96% +/- 3% versus 96% +/- 4%, and 87% +/- 5% versus 81% +/- 8%, respectively (P = NS). Propensity analysis showed similar results. Recurrent (3+ or 4+) mitral regurgitation was found in 22% and 47% at late follow-up, respectively.In patients with moderate ischemic mitral regurgitation, either surgical approach led to an improvement in functional class. Early and intermediate-term mortality rates were low with either CABG or CABG+MVr. However, an increased rate of late recurrent mitral regurgitation in the CABG+MVr group was observed.

Authors+Show Affiliations

Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19876417

Citation

Goland, Sorel, et al. "Coronary Revascularization Alone or With Mitral Valve Repair: Outcomes in Patients With Moderate Ischemic Mitral Regurgitation." Texas Heart Institute Journal, vol. 36, no. 5, 2009, pp. 416-24.
Goland S, Czer LS, Siegel RJ, et al. Coronary revascularization alone or with mitral valve repair: outcomes in patients with moderate ischemic mitral regurgitation. Tex Heart Inst J. 2009;36(5):416-24.
Goland, S., Czer, L. S., Siegel, R. J., DeRobertis, M. A., Mirocha, J., Zivari, K., ... Trento, A. (2009). Coronary revascularization alone or with mitral valve repair: outcomes in patients with moderate ischemic mitral regurgitation. Texas Heart Institute Journal, 36(5), pp. 416-24.
Goland S, et al. Coronary Revascularization Alone or With Mitral Valve Repair: Outcomes in Patients With Moderate Ischemic Mitral Regurgitation. Tex Heart Inst J. 2009;36(5):416-24. PubMed PMID: 19876417.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coronary revascularization alone or with mitral valve repair: outcomes in patients with moderate ischemic mitral regurgitation. AU - Goland,Sorel, AU - Czer,Lawrence S C, AU - Siegel,Robert J, AU - DeRobertis,Michele A, AU - Mirocha,James, AU - Zivari,Kaveh, AU - Kass,Robert M, AU - Raissi,Sharo, AU - Fontana,Gregory, AU - Cheng,Wen, AU - Trento,Alfredo, PY - 2009/10/31/entrez PY - 2009/10/31/pubmed PY - 2010/2/2/medline KW - Cardiac surgical procedures KW - coronary artery bypass KW - coronary disease/complications/surgery KW - disease-free survival/trends KW - matched-pair analysis KW - mitral valve insufficiency/physiopathology/surgery KW - multivariate analysis KW - myocardial ischemia/complications/surgery KW - myocardial revascularization/methods/statistics & numerical data KW - postoperative period KW - recurrence KW - risk assessment SP - 416 EP - 24 JF - Texas Heart Institute journal JO - Tex Heart Inst J VL - 36 IS - 5 N2 - We sought to evaluate retrospectively the outcomes of patients at our hospital who had moderate ischemic mitral regurgitation and who underwent coronary artery bypass grafting (CABG) alone or with concomitant mitral valve repair (CABG+MVr).A total of 83 patients had a reduced left ventricular ejection fraction and moderate mitral regurgitation: 28 patients underwent CABG+MVr, and 55 underwent CABG alone. Changes in mitral regurgitation, functional class, and left ventricular ejection fraction were compared in both groups.The mean follow-up was 5.1 +/- 3.6 years (range, 0.1-15.1 yr). Reduction of 2 mitral-regurgitation grades was found in 85% of CABG+MVr patients versus 14% of CABG-only patients (P < 0.0001) at 1 year, and in 56% versus 14% at 5 years, respectively (P = 0.1), as well as improvements in left ventricular ejection fraction and functional class. One- and 5-year survival rates were similar in the CABG+MVr and CABG-only groups: 96% +/- 3% versus 96% +/- 4%, and 87% +/- 5% versus 81% +/- 8%, respectively (P = NS). Propensity analysis showed similar results. Recurrent (3+ or 4+) mitral regurgitation was found in 22% and 47% at late follow-up, respectively.In patients with moderate ischemic mitral regurgitation, either surgical approach led to an improvement in functional class. Early and intermediate-term mortality rates were low with either CABG or CABG+MVr. However, an increased rate of late recurrent mitral regurgitation in the CABG+MVr group was observed. SN - 1526-6702 UR - https://www.unboundmedicine.com/medline/citation/19876417/Coronary_revascularization_alone_or_with_mitral_valve_repair:_outcomes_in_patients_with_moderate_ischemic_mitral_regurgitation_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=19876417.ui DB - PRIME DP - Unbound Medicine ER -