title: Surgical strategy for moderate ischemic mitral valve regurgitation: repair or ignore?
abstract: BACKGROUND
  Ischemic heart disease is a significant complication of atherosclerosis. Myocardial infarction after the development of coronary artery disease can lead to a number of serious complications, including ischemic mitral regurgitation (IMR). Currently there is no consensus regarding the preferred therapeutic modality for moderately severe IMR. In this study, the postoperative outcome of concomitant coronary artery bypass (CABG) and mitral valve repair was compared with that of CABG alone in two groups of patients with moderately severe IMR.
  
  
  METHODS
  A total of 84 patients who underwent operations for coronary artery disease and moderately severe IMR were included in the study. Preoperative demographic and clinical characteristics were recorded at the time of admission. The severity of mitral regurgitation was graded using transthoracic echocardiography and left ventriculography.
  
  
  RESULTS
  Significant postoperative improvements were observed in ejection fraction and systolic diameter compared to preoperative values (P = .006 and P = .020 respectively, in the intervention group, P = .001 and P = .001 respectively, in the control group). The decrease in pulmonary artery pressure (PAP) was significant only in the intervention group (P = .001). There was a significantly marked reduction in the severity of IMR in the intervention group compared to control.
  
  
  CONCLUSIONS
  Surgical repair of the mitral valve in conjunction with CABG for moderately severe IMR appears to be more effective than isolated CABG for certain outcome parameters, including decreased severity of mitral regurgitation and decreased pulmonary artery pressure.
authors.affiliation: Department of Cardiovascular Surgery, Hitit University Faculty of Medicine, Corum, Turkey.
authors.forename: Adem I
authors.initials: AI
authors.lastname: Diken
authors.affiliation: Department of Cardiovascular Surgery, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.
authors.forename: Garip
authors.initials: G
authors.lastname: Altıntaş
authors.affiliation: Department of Cardiovascular Surgery, Hitit University Faculty of Medicine, Corum, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Yalçınkaya
authors.affiliation: Department of Cardiovascular Surgery, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Lafçı
authors.affiliation: Department of Cardiovascular Surgery, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Hanedan
authors.affiliation: Department of Cardiovascular Surgery, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.
authors.forename: Kerim
authors.initials: K
authors.lastname: Cağlı
mesh_terms: D000465:Algorithms; D058385:Cardiac Valve Annuloplasty / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome