Should Mild-to-Moderate and Moderate Ischemic Mitral Regurgitation Be Corrected in Patients with Impaired Left Ventricular Function Undergoing Simultaneous Coronary Revascularization?

Abstract

MV repair and replacement-preserving subvalvular apparatus in patients with impaired LV function offered acceptable outcomes in terms of morbidity and survival. Surgical correction of mild-to-moderate and moderate MR in patients with impaired LV function should be taken into consideration since it yields better survival and improved LV function.

2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease

“…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. [623][624][625][626][627][633][634][635][636][637][638][639][640][641][642] Mitral annuloplasty alone with a downsized annuloplasty ring is often effective at relieving MR. 637,638,641 In severe MR secondary to acute myocardial infarction, hypotension and pulmonary edema often occur. Severe MR occurs in 6% to 7% of patients with cardiogenic shock.…”

Resultados alejados de la cirugía reparadora de la insuficiencia mitral isquémica

“…La mortalidad operatoria de nuestra serie es comparable a otras series internacionales, y como éstas, signifi cativamente mayor a la mortalidad de la cirugía reparadora de la insufi ciencia mitral degenerativa 2,3,[34][35][36] . Igualmente, la mortalidad no fue signifi cativamente menor a la de nuestra experiencia inicial que incluyó pacientes operados hasta 1999 (10% vs 13%) 33 .…”

“…Nuevamente, la supervivencia alejada de nuestros pacientes, comparable a otras series, de 79%, 72% y 65% a 1, 3 y 5 años, respectivamente, marcadamente menor a pacientes operados por insufi ciencia mitral degenerativa, traduce claramente que el factor determinante en la supervivencia es la función del ventrículo izquierdo 2,3,[34][35][36][37] . Como quiera que sea, la corrección de la insufi ciencia mitral, como se ha demostrado en las grandes series de la Clínica Mayo, hace que estos pacientes tengan una sobrevida similar a aquellos que habiendo sufrido un infarto miocárdico no desarrollaron insufi ciencia mitral 2,3,13,14 .…”

Ischemic Mitral Regurgitation: From New Understanding to New Solutions Role of Echocardiography

“…It is controversial whether concomitant mitral valve procedure has incremental benefit or not with reports describing beneficial effects [133][134][135][136] and others reporting no significant benefit [137]. The variable conclusions can be related to the absence of standard J Echocardiogr Vol.4, No.…”