Ischemic mitral regurgitation.
At a time when hospital mortality for adult cardiac operations is continuing to fall, the ischemic mitral regurgitation subset remains at relatively high risk. Based on analysis of available data, efforts to improve results might be directed toward a more general application of mitral valve reconstruction in this population. Other promising therapeutic measures include the liberal use of reperfusion therapy in the acute papillary muscle dysfunction group, better selection of patients for operation, and, perhaps, operative recommendation to a greater proportion of the more stable patients who previously were treated medically. Incorporating these therapeutic concepts into routine clinical practice may improve the overall prognosis of this difficult subgroup.
Rankin
J S
JS
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710.
Hickey
M S
MS
Smith
L R
LR
Muhlbaier
L
L
Reves
J G
JG
Pryor
D B
DB
Wechsler
A S
AS
D000206:Actuarial Analysis; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve; D008944:Mitral Valve Insufficiency / Q000401:mortality* / Q000601:surgery; D009203:Myocardial Infarction / Q000150:complications; D015425:Myocardial Reperfusion; D012307:Risk Factors