Surgery treatment of ischemic mitral regurgitation / 中华胸心血管外科杂志

ABSTRACT

Ovbective To report our experience of surgical treatment for ischemic mitral regurgitation. Methods From April 1998 to November 2003,44 patients with ischemic mitral valve regurgitation underwent mitral valve plasty (MVP,30) or replacement (MVR,14) and CABG. There were 7 cases with mild-moderate MI,24 with moderate MI,13 with severe MI before operation. The procedures of MVP included commissural annuloplasty in 12,posterior ring annuloplasty in 15,Carpetier's ring annuloplasty in 2,qurdrangular valvulectomy in 4,cordal transplantation in 1,and "double-orifice" technique in 1. Mechanical valves were implanted in 12 MVR patients and biological in 2. Results There were 7 operative deaths (15.9%). The causes of death were heart failure in 4 cases,arrhythmia in 2 and strode in 1. 33 patients were followed up to a mean period of 20 months. There was 2 late death. 29 patients were in NYHA functional class I and II,3 in class III. UCG examination for MVP patients showed no pr trivial MI in 12 patients,mild in 5,moderate in 2 cases. LV size decreased significantly [(62.3?6.3) mm vs. (54.3?7.1)mm]. There was 1 case of perivalvular leak in MVR group. Statistical analysis showed severe preoperative symptom,significantly enlarged LV size and severely depressed LV function were risk factors of operative death. Conclusion Coronary artery desease with ischemic mitral regurgiatation should be treated aggressively. Operative technique should be based on valve pathology. Valve repair should be considered if possible.