Long-term Influence of Mild to Moderate Ischemic Mitral Regurgitation after Off-pump Coronary Artery Bypass Surgery / 대한흉부외과학회지
The Korean Journal of Thoracic and Cardiovascular Surgery
;
: 246-253, 2010.
Artigo
em Inglês
| WPRIM
| ID: wpr-220841
ABSTRACT
BACKGROUND:
Our objective was to review the long-term prognosis of patients with preoperative mild to moderate ischemic mitral regurgitation who underwent off-pump coronary artery bypass grafting. MATERIAL ANDMETHOD:
We prospectively followed 1,000 consecutive and systematic off-pump coronary artery bypass grafting patients who were operated on between September 1996 and March 2004; follow-up was achieved for 97%. Sixty-seven patients (6.7%) had mild to moderate ischemic mitral regurgitation at the time of surgery. Operative mortality, actuarial survival and major adverse cardiac event free survival were compared to assess the effect of ischemic mitral regurgitation.RESULT:
Average follow-up was 66+/-22 months. Patients with ischemic mitral regurgitation were older (p<0.001), had lower ejection fractions (p<0.001) and more comorbidities. Significantly more female patients presented with ischemic mitral regurgitation (p=0.002). There was no significant difference in operative mortality and perioperative myocardial infarction in ischemic mitral regurgitation patients (p=0.25). Eight-year survival was decreased in ischemic mitral regurgitation patients (39.6+/-11.8% vs 76.7+/-2.2%, p<0.001). However, after correcting for risk factors, mild to moderate ischemic mitral regurgitation was not found to be a significant independent risk factor for long-term mortality (p=0.42). Major adverse cardiac event free survival at 8 years was significantly lower in ischemic mitral regurgitation patients (53+/-12% vs 77+/-2%, p<0.001). After correction for risk factors, ischemic mitral regurgitation remained a significant independent cause of major adverse cardiac events (HR 2.31), especially congestive heart failure and recurrent myocardial infarction.CONCLUSION:
In our series, patients with preoperative mild to moderate ischemic mitral regurgitation had a higher prevalence of preoperative risk factors than patients without ischemic mitral regurgitation. They had comparable perioperative mortality and morbidity, but, in the long term, were found to be at elevated risk for recurrent cardiac events.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Prognóstico
/
Comorbidade
/
Prevalência
/
Estudos Prospectivos
/
Fatores de Risco
/
Seguimentos
/
Intervalo Livre de Doença
/
Transplantes
/
Ponte de Artéria Coronária sem Circulação Extracorpórea
/
Insuficiência Cardíaca
Tipo de estudo:
Estudo de etiologia
/
Estudo observacional
/
Estudo de prevalência
/
Estudo prognóstico
/
Fatores de risco
Limite:
Feminino
/
Humanos
Idioma:
Inglês
Revista:
The Korean Journal of Thoracic and Cardiovascular Surgery
Ano de publicação:
2010
Tipo de documento:
Artigo
Similares
MEDLINE
...
LILACS
LIS