title: Does Surgical Repair of Moderate Ischemic Mitral Regurgitation Improve Survival? A Systematic Review.
abstract: Mitral regurgitation (MR) is one of the common complications in myocardial infarction (MI) patients. Almost half of the post MI patients have MR (ischemic MR)(17) which is moderate to severe (grade II-IV). Whether there is a mortality benefit of performing mitral valve repair (MVR) along with coronary artery bypass grafting (CABG) in patients with post MI moderate MR remains inconclusive. Literature search was done from PubMed, Google scholar, Ovid, and Medline databases. Studies which included post MI patients with moderate ischemic MR and reported mortality outcomes of performing CABG and MVR were chosen for the systematic review. Our preliminary literature search identified 194 studies, of which 11 studies met our inclusion criteria. Nine studies showed no survival benefit of performing simultaneous MVR and CABG. One study demonstrated survival benefit of performing CABG plus MVR only in the New York Heart Association (NYHA) class III-IV, and one study suggested survival benefit of performing CABG plus MVR as compared to CABG alone in patient with ischemic MR irrespective of preoperative NYHA functional class. Review of current literature showed mixed results in terms of improvement in functional status but failed to show any survival benefit of performing MVR along with CABG. Limitations of studies include small sample size, difference in baseline demographic variables, and short follow-up period which might influence the outcome of the study. Prospective randomized studies are required to establish clear benefit of performing MVR simultaneously with CABG.
authors.affiliation: Cardiovascular Diseases, Division of Cardiology, Mount Sinai St. Luke's Roosevelt Hospitals, 1111 Amsterdam Avenue, Clark building 3rd floor, New York, NY, 10025, USA. schatterjee@chpnet.org.
authors.forename: Saurav
authors.initials: S
authors.lastname: Chatterjee
authors.affiliation: Cardiovascular Diseases, Division of Cardiology, Mount Sinai St. Luke's Roosevelt Hospitals, 1111 Amsterdam Avenue, Clark building 3rd floor, New York, NY, 10025, USA.
authors.forename: Byomesh
authors.initials: B
authors.lastname: Tripathi
authors.affiliation: Cardiovascular Diseases, Division of Cardiology, Mount Sinai St. Luke's Roosevelt Hospitals, 1111 Amsterdam Avenue, Clark building 3rd floor, New York, NY, 10025, USA.
authors.forename: Hafeez Ul Hassan
authors.initials: HU
authors.lastname: Virk
authors.affiliation: Cardiovascular Diseases, Division of Cardiology, Mount Sinai St. Luke's Roosevelt Hospitals, 1111 Amsterdam Avenue, Clark building 3rd floor, New York, NY, 10025, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ahmed
authors.affiliation: Cardiovascular Diseases, Division of Cardiology, Mount Sinai St. Luke's Roosevelt Hospitals, 1111 Amsterdam Avenue, Clark building 3rd floor, New York, NY, 10025, USA.
authors.forename: Chirag
authors.initials: C
authors.lastname: Bavishi
authors.affiliation: Division of Cardiology, Albert Einstein Medical Center, Philadelphia, PA, USA.
authors.forename: Parasuram
authors.initials: P
authors.lastname: Krishnamoorthy
authors.affiliation: Division of Cardiology, University of Utah, Salt Lake City, UT, USA.
authors.forename: Partha
authors.initials: P
authors.lastname: Sardar
authors.affiliation: Division of Cardiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Giri
authors.affiliation: Cardiovascular Diseases, Division of Cardiology, Mount Sinai St. Luke's Roosevelt Hospitals, 1111 Amsterdam Avenue, Clark building 3rd floor, New York, NY, 10025, USA.|Department of Cardiothoracic Surgery, Icahn School of Medicine, Mount Sinai St. Luke's Roosevelt Hospital, New York, NY, USA.
authors.forename: Karan
authors.initials: K
authors.lastname: Omidvari
authors.affiliation: Cardiovascular Diseases, Division of Cardiology, Mount Sinai St. Luke's Roosevelt Hospitals, 1111 Amsterdam Avenue, Clark building 3rd floor, New York, NY, 10025, USA.|Department of Cardiothoracic Surgery, Icahn School of Medicine, Mount Sinai St. Luke's Roosevelt Hospital, New York, NY, USA.
authors.forename: Joanna
authors.initials: J
authors.lastname: Chikwe
mesh_terms: D001026:Coronary Artery Bypass; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000601:surgery; D016019:Survival Analysis
keywords: Moderate ischemic mitral regurgitation; Surgical repair; Systemic review
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