[Surgical treatment of ischemic mitral regurgitation].
Mitral regurgitation secondary to ischemic heart disease carries a significant mortality even after emergent open heart surgery. We report on 16 patients with mitral regurgitation associated with ischemic heart disease. The pathological findings were chorda elongation and papillary muscle dysfunction (PMD group) in 12 patients, and papillary muscle rupture (PR group in 4 patients. Preoperative characteristics were severe left ventricular failure in PMD group and high incidence of renal failure, in associated with high age in PR group. In PMD group, mitral plasty was performed in 10 patients out of 12 patients. In PR group all patients underwent mitral valve replacement. Thirteen patients underwent mitral surgery combined with coronary artery bypass grafting. No operative death was seen, one hospital death and 3 late deaths occurred. Three late deaths were seen in PMD group due to sudden death in 2 cases and arrhythmia in 1 case. One hospital death in PR group was due to multi-organ failure. We suggested incorporating these therapeutic concepts may introduce satisfactory results in surgical treatment for ischemic mitral regurgitation.
Hachida
M
M
Department of Cardiovascular Surgery, Tokyo Women's Medical College, Japan.
Endo
M
M
Bonkohara
Y
Y
Nonoyama
M
M
Uchita
S
S
Nishida
H
H
Hashimoto
A
A
Koyanagi
H
H
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006341:Heart Rupture / Q000150:complications; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D017202:Myocardial Ischemia / Q000150:complications*; D010210:Papillary Muscles / Q000503:physiopathology