Revascularization alone (without mitral valve repair) suffices in patients with advanced ischemic cardiomyopathy and mild-to-moderate mitral regurgitation

ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease

“…Other less common causes of MR that requires surgery are infective endocarditis and rheumatic heart disease. Because the change in hemodynamic loading conditions caused by general anesthesia during surgery may lead to underestimation of the severity of MR by intraoperative transesophageal echocardiography (632,633,931,932), the decision to operate is best made before surgery based on the symptoms and preoperative testing. If intraoperative evaluation is required as a precursor to MV repair or replacement, the operator must attempt to reproduce both preoperative afterload and preload conditions.…”

Ischemic Mitral Regurgitation on the Threshold of a Solution

“…129 MR severity and LV dysfunction vary widely in these studies, and whether MR actually decreases is frequently unknown. How can we reasonably evaluate the benefit of eliminating MR when it frequently persists or recurs with standard therapies?…”

ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary

“…Patients with ischemic heart disease who have MR have a worse prognosis than those without MR (391)(392)(393)(394). CABG alone may improve LV function and reduce ischemic MR in selected patients (392,395), especially those with transient severe MR due to ischemia, in whom myocardial revascularization can eliminate episodes of severe MR. However, CABG alone is usually insufficient and leaves many patients with significant residual MR, and these patients would benefit from concomitant MV repair at the time of the CABG (386 -390,396 -405).…”