ObjectiveTo investigate the mid- and long-term outcomes of case-based selective
strategy of mitral ring annuloplasty during coronary artery bypass grafting
in patients with coronary artery disease accompanied by chronic ischemic
mitral regurgitation.Methods132 patients who were diagnosed ischemic moderate to severe mitral
regurgitation undergoing coronary artery bypass grafting in the same center
with the same surgical team were divided into 2 groups and investigated
retrospectively. Patients undergoing simultaneous mitral ring annuloplasty
and coronary artery bypass grafting were enrolled to group 1 (n=58),
patients undergoing isolated coronary artery bypass grafting were enrolled
in group 2 (n=74).ResultsThe mean age of the patients were 65.0 ± 9.4 years and 39 (29.5%) of
them were female. Preoperative New York Heart Association (NHYA) class
(P=0.0001), atrial fibrillation
(P=0.006) and the grade of mitral regurgitation
(P=0.0001) were significantly different between the
groups. Hospitalization for heart failure was required in 6 (10.6%) patients
in group 1 and 19 (27.1%) patients in Group 2 (P=0.02).
Hospital mortality and one-month postoperative mortality occurred in 2
(3.4%) patients in Group 1 and in 4 (5.4%) patients in Group 2
(P=0.69). Clinical follow-up was completed with 117
(88.6%) patients.ConclusionMitral ring annuloplasty in addition to the coronary artery bypass grafting
is associated with improved NYHA functional class, increased ejection
fraction, decreased residual mitral regurgitation. Further studies are
needed to clarify the role of combined surgery on long-term outcomes. With
proper tools and according to the decisions made by heart teams, both
management strategies can be safely performed.