Results of surgical coronary revascularization alone versus combined surgical revascularization and mitral valve repair in patients with moderate ischemic mitral regurgitation

Abstract

Background: This is a prospective randomized-controlled study aiming to determine whether the optimal surgical management of moderate ischemic mitral regurgitation is to revascularize the heart through performing coronary artery bypass grafting alone or together with repairing the mitral valve. Methods: Between April 2014 and November 2014, 40 patients with ischemic heart disease associated with moderate ischemic mitral regurgitation at our University hospitals were divided into 2 matched groups. Group 1 received both coronary artery bypass grafting surgery together with mitral valve repair, while Group 2 underwent coronary artery bypass grafting surgery alone. Results: No statistically significant difference was found between both study groups, in terms of operative data, except for cardiopulmonary bypass time and aortic cross-clamp time, which were significantly longer in Group 1 (P < .001). Only one case died in the study in Group 1 on the third postoperative day, due to severe low cardiac output syndrome. During the follow up, NYHA class improved in Group 1 from 2.6 to 1.35 (P < .004), but in Group 2 NYHA class improved from 2.55 to 1.72 (P = .07). The degree of MR improved in 19 patients (95%) in Group 1 compared with 15 (75%) patients in Group 2 (P < .0001). Conclusion: Our study showed meaningful advantages of adding mitral-valve repair to CABG in patients with ischemic heart disease and moderate ischemic mitral regurgitation, regarding the degree of MR and functional NYHA class. On the other hand, there was no statistically significant difference between both groups in postoperative coarse and in-hospital mortality.