Chronic ischemic mitral regurgitation: repair, replace or rethink?
Ischemic mitral regurgitation (IMR) is a common complication of coronary artery disease and is the focus of a rapidly increasing amount of research. Mechanistic studies have determined that IMR is caused by apical displacement and tethering of the mitral valve leaflets after myocardial infarction, resulting in incomplete coaptation. Despite the relatively high prevalence of IMR, most centers have only a small surgical experience with this disorder. The result is that a number of different procedures have been recently developed without clear improvement in patient outcomes. The current review will examine the myriad surgical options for IMR with a focus on clinical outcomes.
Borger
Michael A
MA
Division of Cardiovascular Surgery, Department of Anesthesia, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada. michael.borger@uhn.on.ca
Alam
Asim
A
Murphy
Patricia M
PM
Doenst
Torsten
T
David
Tirone E
TE
D002908:Chronic Disease; D003327:Coronary Disease / Q000150:complications; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D017202:Myocardial Ischemia / Q000209:etiology