title: A good surgical option for ischemic mitral regurgitation in co-morbid patients: semicircular reduction annuloplasty.
abstract: BACKGROUND
  Ring annuloplasty is the standard treatment of ischemic mitral regurgitation (MR), however, it has been associated with some drawbacks. It abolishes normal annular dynamics and freezes the posterior leaflet. In the present study, we evaluated Paneth suture annuloplasty in chronic ischemic MR and both early and mid-term outcomes of the technique on a selected population.
  
  
  METHODS
  The study period was from June 2010 to June 2012. We operated on 21 patients who had the diagnosis of coronary artery disease and MR of grade 3 or 4. The patients had both a coronary artery bypass operation and the mitral semicircular reduction annuloplasty described by Paneth-Burr. The data on the patients were retrospectively collected. Patients were contacted by outpatient clinic controls for mid-term results.
  
  
  RESULTS
  The male/female ratio was 10/11. The mean age of the patients was 71.0 ± 6.4 years. Preoperative and postoperative left ventricular ejection fraction was statistically similar (P = 0.973). Early postoperative MR grade (mean, 0.57 ± 0.51) was statistically lower than the preoperative MR grades (mean, 3.38 ± 0.50) (P < 0.001). There was no revision for excess bleeding. Two patients had prolonged hospitalization, one for sternal infection and the other for severe chronic obstructive pulmonary disease. No hospital or late postoperative deaths occurred. The mean late postoperative MR grade was 0.66 ± 0.97 degrees. One patient had progression of MR in the later follow-up, which was treated by mitral valve replacement.
  
  
  CONCLUSIONS
  Semicircular reduction annuloplasty is an effective, inexpensive and easy surgical annuloplasty technique with low mortality and morbidity in severe symptomatic ischemic MR.
authors.affiliation: Department of Cardiac and Vascular Surgery, Pamukkale University, Kınıklı, Denizli 20070, Turkey.
authors.forename: Bilgin
authors.initials: B
authors.lastname: Emrecan
authors.forename: Gokhan
authors.initials: G
authors.lastname: Onem
authors.forename: Ahmet Coskun
authors.initials: AC
authors.lastname: Ozdemir
authors.forename: Ismail Doğu
authors.initials: ID
authors.lastname: Kılıç
authors.forename: Yusuf İzzettin
authors.initials: Yİ
authors.lastname: Alihanoğlu
keywords: Mitral valve; Myocardial ischemia; Surgery