Ring annuloplasty in chronic ischemic mitral regurgitation: encouraging early and midterm results.
Ischemic mitral regurgitation, a complication of myocardial infarction, is associated with a poor prognosis and can result in postinfarction congestive heart failure. The preferred treatment of its chronic form is a matter of debate. Herein, we report the early and midterm results in 44 patients with chronic ischemic mitral regurgitation in whom concomitant mitral ring annuloplasty and coronary revascularization were performed at our hospital. We reviewed their medical records. The patients had grades 3/4 and 4/4 chronic ischemic mitral regurgitation, or grade 2/4 regurgitation with left ventricular dilation and low left ventricular ejection fraction. All received circular, flexible annuloplasty rings. Four patients died during the early postoperative period due to low cardiac output (9.1%). At the last follow-up echocardiographic examinations, performed a mean 13.14 +/- 4.66 months after the surgical procedures (range, 6-22 mo), the 40 surviving patients were found to have significantly reduced left ventricular end-diastolic (P = 0.029) and end-systolic (P < 0.05) diameters and improved New York Heart Association functional class (P = 0). Despite a risk of residual regurgitation, mitral ring annuloplasty appears to be a good treatment alternative in selected patients who have chronic ischemic mitral regurgitation. We discuss the procedure's rate of hospital mortality, and its potentially positive impact on survival.
Tekumit
Hayrettin
H
Department of Cardiovascular Surgery, Ozel Avrupa Safak Hastanesi, Gaziosmanpasa, 34080 Istanbul, Turkey. htekumit@yahoo.com
Cenal
Ali Riza
AR
Uzun
Kemal
K
Tataroglu
Cenk
C
Akinci
Esat
E
D000368:Aged; D002908:Chronic Disease; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D017202:Myocardial Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D020127:Recovery of Function; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000601:surgery
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