Medium-Term Outcomes Of Surgical Treatment Of Moderate Ischemic Mitral Regurgitation In Patients With Left Ventricular Dysfunction

ObjectiveTo evaluate the short-term and medium-term outcomes of surgical treatment of moderate ischemic mitral regurgitation(IMR)in patients with coronary artery disease(CAD)and left ventricular dysfunction(LVEF < 0.5)and to optimize treatment strategies.MethodsWe enrolled 115 patients with moderate ischemic mitral regurgitation in cardiovascular surgery department of general hospital of north theater PLA from September 2010 to September 2017.They had coronary artery disease(CAD)and left ventricular dysfunction.Among them,69 cases underwent off-pump CABG alone and 46 cases underwent CABG combined with MVP under cardiopulmonary bypass.The short and medium-term data of the two groups were compared and analyzed.The short-term data included clinical indicators(LAD,LVEDD,LVESD,LVEF,sPAP,mitral regurgitation area,NYHA functional class)and the incidence of perioperative events.The medium-term indexes included rates of the cumulative survival and major adverse cardiac and cerebrovascular events,mitral regurgitation area and NYHA functional class.ResultsThere was no statistical difference at general characteristics between two groups(P > 0.05).There were 8 perioperative deaths overall,4 in CABG group(5.7%)and 4 in CABG + MVP group(8.6%),respectively.No significant difference was found between the two groups(P > 0.05).At follow-up,LVEDD,LVESD and LVEF were significantly improved compared with preoperative data in both groups(P < 0.01).And also mitral regurgitation was significantly improved and NYHA functional class was significantly reduced(P < 0.05)in CABG + MVP group than in CABG group.ConclusionsAt short and mid-term follow-up,two group patients can effectively improve the reversal of left ventricular remodeling,adding MVP to CABG can effectively improve mitral regurgitation and reduce NYHA functional class while not increases mortality and adverse events.