title: [Long-term results of mitral valve repair for ischemic mitral insufficiency].
abstract: BACKGROUND
  The preferred treatment for ischemic mitral insufficiency is mitral valve repair with a prosthetic ring, because it does not deteriorate left ventricular function, allowing better immediate and long-term results.
  
  
  OBJECTIVE
  To assess long-term results of mitral annuloplasty with a prosthetic ring for ischemic mitral insufficiency.
  
  
  METHODS
  One hundred patients (68 men), with a mean age of 65.7 ± 8.6 years were included. They underwent a mitral annuloplasty with a prosthetic ring to treat ischemic mitral insufficiency, between February 1992 and May 2009. Forty four had a history of prior myocardial infarction and 46 had an evolving acute coronary syndrome. The inferior left ventricular wall was involved, exclusively or associated with an adjacent wall, in 72 cases. Coronary artery bypass grafts were performed in 92 patients and 32 required intra-aortic balloon pumping at some time during the peri-operative period.
  
  
  RESULTS
  Operative mortality was 10% (10 patients). During follow-up 30 patients died, at an average of 39 months after surgery (range: 3-142 months). Actuarial long-term survival rates at 1, 3 and 5 years were 79%, 72% and 64.5%, respectively. Trans esophageal echocardiogram performed in the operating room showed none or minimal residual mitral insufficiency in 96% of the cases. Echocardiographic follow-up was completed in 80% of the survivors; 79% of them had no or minimal mitral insufficiency. Only one patient was re-operated on due to severe mitral insufficiency and 4 required a permanent pacemaker.
  
  
  CONCLUSIONS
  Considering the critical illness of these patients, good long-term results were observed after treatment of ischemic mitral regurgitation performing a mitral annuloplasty with a prosthetic ring.
authors.affiliation: División de Enfermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile Santiago, Chile. rzalaque@med.puc.cl
authors.forename: Ricardo
authors.initials: R
authors.lastname: Zalaquett S
authors.forename: Emilio
authors.initials: E
authors.lastname: Flores A
authors.forename: Fernando
authors.initials: F
authors.lastname: Cartajena de la M
authors.forename: Pablo
authors.initials: P
authors.lastname: Bächler S
authors.forename: Samuel
authors.initials: S
authors.lastname: Córdova A
authors.forename: Pedro
authors.initials: P
authors.lastname: Becker R
authors.forename: Sergio
authors.initials: S
authors.lastname: Morán V
authors.forename: Manuel
authors.initials: M
authors.lastname: Irarrázabal Ll
authors.forename: Cecilia
authors.initials: C
authors.lastname: Muñoz C
authors.forename: Rodrigo
authors.initials: R
authors.lastname: González F
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects / Q000401:mortality; D008944:Mitral Valve Insufficiency / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data; D015996:Survival Rate; D016896:Treatment Outcome