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ORIGINAL ARTICLE
Year : 2017  |  Volume : 34  |  Issue : 1  |  Page : 10-16

Management of moderate ischemic mitral regurgitation: revascularization alone versus revasularization and mitral valve repair


1 Department of Cardiothoracic Surgery, Faculty of Medicine, Benha University, Benha, Egypt
2 Department of Cardiac Surgery, Faculty of Medicine, Benha University, Benha, Egypt
3 Department of Cardiac Surgery, National Heart Institute, Cairo, Egypt

Correspondence Address:
Medhat N Riad Moussa
42 B Khesrou street, Helwan, Cairo, postal code 114214
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-208X.206901

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Background Ischemic mitral regurgitation (IMR) is a frequent condition post-myocardial infarction. Management of moderate myocardial infarction is still debatable, with adding mitral valve repair (MVR) to coronary artery bypass grafting (CABG) being questionable. Aim To compare echocardiographic and clinical outcome of moderate IMR treated by revascularization alone versus another group of patients treated by revascularization and MVR. Patients and methods Forty consecutive patients with ischemic heart disease with moderate IMR undergoing on-pump CABG are randomly selected. They were divided into two groups: group I (20) had CABG+MVR, group II (20) had only CABG; echocardiography was done postoperatively and after 6 months for both groups. Results Our study revealed improvement in the grade of mitral regurgitation (MR) in both groups which was more evident and significant in group I than II with 11 (61%) of group I showing complete resolution of MR versus 0 patients in group II which was highly statistically significant (P=0.0001). Follow-up after 6 months, there were significant reduction in the New York Heart Association functional class as well as the mean grade of MR in group I versus group II, (P=0.004), with nine (50%) patients in group I against two (11%) patients in group II had complete resolution (P=0.004). We found also significant reduction in left ventricular dimensions and function. Conclusion MVR can be performed safely, concomitantly with coronary artery bypass grafting in patients who have moderate IMR.


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