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Coronary artery bypass grafting versus concomitant mitral valve annuloplasty in moderate ischemic mitral regurgitation: 4-year follow-up

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Objective

In severe ischemic mitral regurgitation (IMR), there is benefit evidence for mitral valve repair with coronary artery bypass grafting (CABG). However, there is still a debate around combined repair and CABG for moderate IMR. We evaluate our results over 4-year follow-up for patients with moderate IMR who underwent isolated CABG and combined with mitral ring annuloplasty.

Methods

We retrospectively studied patients with moderate IMR; 69 patients underwent CABG alone group (A), and 77 patients underwent CABG with mitral valve ring annuloplasty group (B). New York Heart Association functional class (NYHA class), mitral regurgitation (MR) grade, and left ventricle (LV) dimension and ejection fraction (EF) were assessed preoperatively, 1 and 4 years postoperatively.

Results

The mortality rate was 2.9% in group (A) and 1.8% in group (B) p = 0.1593. Improvement in NYHA class, MR, and LVEF % were significant in both groups at 1 year with no significant changes at 4 years. However, group (B) showed significant improvement in LVEF % than group (A) at 4 years (47.5 ± 7.3 vs 44 ± 1.7, p ˂ 0.0001). It showed improvement in NYHA class at 1 and 4 years (1.5 ± 0.4 vs 2.1 ± 0.2) and (1 ± 0.2 vs 1.5 ± 0.5) p ˂ 0.0001, respectively. After 4 years, group (A) showed deterioration of MR degree in 4.3% of patients.

Conclusion

We strongly advise to add mitral valve ring annuloplasty with CABG for patients with moderate IMR.

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Authors and Affiliations

  1. King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia

    Tamer Hamdy Hamouda, Mohamed Fouad Ismail, Ahmed Farid El-Mahrouk, Ahmed Abdullah Jamjoom & Hanan Ibrahim Radwan

  2. Department of Cardiothoracic Surgery, Benha University, Benha, Egypt

    Tamer Hamdy Hamouda

  3. Department of Cardiothoracic Surgery, Mansoura University, Mansoura, Egypt

    Mohamed Fouad Ismail

  4. Department of Cardiothoracic Surgery, Tanta University, Tanta, Egypt

    Ahmed Farid El-Mahrouk

  5. Department of Cardiovascular, Faculty of Medicine, Zagazig University, Zagazig, Sharkia Governorate, Egypt

    Hanan Ibrahim Radwan & Abdelhakem Selem Alsayd Selem

  6. Ibn Sina National Medical College Hospital, Jeddah, Saudi Arabia

    Abdelhakem Selem Alsayd Selem

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  1. Tamer Hamdy Hamouda
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Correspondence to Hanan Ibrahim Radwan.

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Hamouda, T.H., Ismail, M.F., El-Mahrouk, A.F. et al. Coronary artery bypass grafting versus concomitant mitral valve annuloplasty in moderate ischemic mitral regurgitation: 4-year follow-up. Indian J Thorac Cardiovasc Surg 33, 1–8 (2017). https://doi.org/10.1007/s12055-016-0472-z

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  • DOI: https://doi.org/10.1007/s12055-016-0472-z

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