Treatment of severe functional mitral regurgitation: is cardiac surgery always indicated?
Severe functional mitral regurgitation associated with myocardial ischemia is conventionally a Class I indication for cardiac surgery. Mitral annuloplasty or mitral valve replacement are performed during coronary bypass surgery with the aim of improving the patient's ventricular function and symptoms. With the advancement of stent technology, sustained myocardial perfusion and improvement of ventricular function could be achieved by revascularization alone, leading to a reduction in the severity of mitral regurgitation. The purpose of this case is to review the role of transcatheter coronary revascularization in the management of myocardial ischemia associated with severe functional mitral regurgitation and heart failure.
Chan
Albert W
AW
Department of Cardiovascular Services, Royal Columbian Hospital, 301 E. Columbia Street, Suite 206, New Westminster, British Columbia, V3L 3W5, Canada. albertwchan@shaw.ca
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D006348:Cardiac Surgical Procedures; D017023:Coronary Angiography; D054855:Drug-Eluting Stents; D015150:Echocardiography, Doppler; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000628:therapy*; D012720:Severity of Illness Index