Predictive risk factors for early mortality in operative treatment for chronic ischemic mitral insufficiency.
BACKGROUND
The combination of coronary artery bypass grafting and mitral valve surgeries is closely associated with high in-hospital mortality and morbidity. In this study, we sought to analyze the factors that influence early mortality in 68 patients undergoing coronary artery bypass grafting + mitral valve surgery due to ischemic mitral insufficiency.


METHODS
Of 1183 patients undergoing coronary bypass surgery between April 2002 and June 2006, 68 patients (42 male and 26 female) 42 to 78 years of age (mean +/- SD, 59.3 +/- 9.1) underwent mitral valve surgery accompanying coronary bypass surgery (survival, n = 59; mortality, n = 9). The cases were analyzed regarding the demographic, preoperative, and perioperative risk factors that influence mortality.


RESULTS
The early mortality rate was found to be 13.2% (9/68) in patients with ischemic mitral regurgitation undergoing simultaneous coronary bypass and mitral valve surgeries. New York Heart Association class > or =3, left ventricle end-systolic volume, left ventricle end-systolic diameter, cardiopulmonary perfusion time, preoperative unstable angina pectoris, intra-aortic balloon application, and age >65 years were determined to be statistically significant risk factors that influence early in-hospital mortality.Conclusion. Surgery, despite having a high mortality risk in patients with ischemic mitral insufficiency, is considered to be a treatment measure that generally improves the quality of life and prolongs life.
Burma
Oktay
O
Department of Cardiovascular Surgery, School of Medicine, Gaziantep University, Gaziantep, Turkey. oburma@hotmail.com <oburma@hotmail.com>
Ustunsoy
Hasim
H
Celkan
M Adnan
MA
Davutoglu
Vedat
V
Kazaz
Hakki
H
Atik
Cem
C
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003131:Combined Modality Therapy / Q000401:mortality; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000401:mortality*; D018572:Disease-Free Survival; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000401:mortality* / Q000601:surgery*; D017202:Myocardial Ischemia / Q000401:mortality* / Q000601:surgery*; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013534:Survival; D015996:Survival Rate; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology