Mild or moderate ischemic mitral regurgitation in patients undergoing off-pump coronary artery bypass grafting.
BACKGROUND
There has been a debate, whether mild or moderate ischemic mitral regurgitation (IMR) should be repaired at the time of coronary bypass surgery. We assessed the early and midterm outcomes of patients with mild or moderate IMR who underwent isolated off-pump coronary artery bypass grafting (OPCAB).


METHODS
We retrospectively reviewed records of 602 patients who underwent OPCAB between April 2001 and July 2004. Of those, 96 patients had mild or moderate MR (IMR group), and 506 had none or trivial MR (no IMR group). Preoperative and postoperative characteristics were compared between the groups. Furthermore, fates of grade of MR and functional status were investigated in patients with IMR.


RESULTS
The preoperative mean New York Heart Association (NYHA) classes were 2.7 +/- 1.0 and 2.4 +/- 0.9 in the IMR and no IMR groups, respectively (p < 0.01). Operative mortality was similar between groups (1.0% in the IMR group and 0.4% in no IMR group, p = 0.41). The cumulative survival rate for the IMR group was 93.7% at 1 year and 90.1% at 4 years. The mean NYHA class was 1.1 +/- 0.4 (p < 0.0001) at 28.8 +/- 11.4 months after operation for the IMR group. The mean grade of mitral regurgitation diminished (from 2.2 +/- 0.4 to 1.1 +/- 0.6, p < 0.0001) soon after operation in patients with IMR, and remained so (1.1 +/- 0.8, p < 0.0001) during the follow-up period.


CONCLUSIONS
Mild or moderate IMR could be improved with isolated OPCAB. The early and midterm functional outcomes of these patients were favorable.
Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. tm-fukui@gem.hi-ho.ne.jp
Toshihiro
T
Fukui
Shuichiro
S
Takanashi
Minoru
M
Tabata
Yasuyuki
Y
Hosoda
D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000209:etiology* / Q000401:mortality; D017202:Myocardial Ischemia / Q000209:etiology* / Q000401:mortality; D011183:Postoperative Complications; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome