[Change of mitral regurgitation before and after myocardial revascularization--is mitral repair required for ischemic mitral regurgitation?].
In twenty seven patients, intraoperative change of ischemic mitral regurgitation before and after coronary artery bypass grafting (CABG) was assessed using transesophageal echocardiography. The size of mitral regurgitation (MR) was determined by the area of MR color flow on the doppler echocardiogram. After CABG, MR area decreased in 20 patients (average: 3.7 cm2-->1.5 cm2), unchanged in one patient and increased in 6 patients (average: 17 cm2-->2.9 cm2). The change of MR area corresponded with the change of mitral annular diameter in 23 patients but uncorresponded in 2 patients. MR areas correlated exponentially with mitral annular diameters and the fair linear relation was observed between the postoperative to preoperative ratio of MR area and the postoperative increase in mitral annular diameter with the correlation of r = 0.81. When the larger MR area or mitral annular diameter before CABG was observed, the larger MR area after CABG remained, but annular diameter before CABG had more effect on postoperative MR area. No significant correlation was found between MR area and infarcted region, revascularized region, segmental wall motion etc. In conclusion, when the moderate or marked mitral annular dilatation was found in association with prominent ischemic mitral regurgitation, mitral annuloplasty with CABG should be considered.
Nishiwaki
M
M
Department of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Japan.
Ogawa
K
K
Asada
T
T
Mukouhara
N
N
Higami
T
T
Sugimoto
T
T
Nishio
W
W
Nakagiri
K
K
Kawamura
T
T
D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D017202:Myocardial Ischemia / Q000150:complications / Q000601:surgery*