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January 1, 2024Journal of Medicine in Scientific ResearchOpen Access

Repair Versus Replacement for Ischemic Mitral Regurgitation In Patients Who Underwent Coronary Artery Bypass Grafting Plus Mitral Valve Surgery

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Key result

Mitral valve repair with CABG is linked to higher recurrent MR versus replacement.

  • P<0.001
  • n=100

Why the study?

The optimal surgical management of ischemic mitral regurgitation is controversial, with limited evidence supporting mitral valve repair versus replacement during concomitant CABG.

Does mitral valve repair compared to mitral valve replacement improve early outcomes in patients undergoing concomitant CABG for ischemic mitral regurgitation?

Population

100 patients undergoing concomitant CABG and mitral valve surgery for IMR

Comparison

MVr vs MVR

Design

Retrospective comparative study

Authors

RORamdan Ibrahim Mohammed OufBRBassem Ashraf Ahmed Roushdy

Discussion

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Overview

Repair should not yet supplant replacement in ischemic MR with CABG; leaves open durability and survival questions for randomized trials.

Key Points

  • To compare the early surgical outcomes of mitral valve repair versus mitral valve replacement in patients with ischemic mitral regurgitation undergoing concomitant coronary artery bypass grafting.
  • Retrospective comparative study of N=100 patients undergoing combined coronary artery bypass grafting and mitral valve surgery between August 2021 and August 2023 at the National Heart Institute.
  • Patients were allocated to either mitral valve repair (n=50) or mitral valve replacement (n=50) and evaluated across distinct subgroups.
  • Early mortality ranged from 5% to 10% in the mitral valve repair subgroups and from 3.3% to 10% in the mitral valve replacement subgroups.
  • Patients undergoing mitral valve repair demonstrated a significantly higher incidence of residual or recurrent mitral regurgitation compared to those receiving valve replacement (P < 0.001).

Study Design

Type

Observational (n=100)

Multicenter

No

Structured PICO

Does mitral valve repair compared to mitral valve replacement improve early outcomes in patients undergoing concomitant CABG for ischemic mitral regurgitation?

P
Population
100 patients with chronic ischemic mitral regurgitation (> grade II) undergoing elective concomitant coronary artery bypass grafting (CABG) and mitral valve surgery at the National Heart Institute, Egypt.
I
Intervention
Mitral valve repair (MVr) with concomitant CABG (n=50, divided into moderate MR [n=20] and severe MR [n=30] subgroups).
C
Comparator
Mitral valve replacement (MVR) with concomitant CABG (n=50, divided into moderate MR [n=20] and severe MR [n=30] subgroups).
O
Outcome
Early outcomes including early mortality, morbidities, and postoperative degrees of severity of mitral regurgitation.hard clinical

Main Result

p-value: p=<0.001

In patients with ischemic mitral regurgitation undergoing CABG, mitral valve repair and replacement have similar early mortality and morbidity, but repair is associated with a higher incidence of residual or recurrent mitral regurgitation.

Limitations

  • Retrospective nature
  • Small sample size
  • Lack of intraoperative transesophageal echocardiography
  • Decision to conduct simultaneous MVR was based on surgical factors and preferences (selection bias)

Cite This Study

Ouf et al. (2024) conducted an observational in Ischemic mitral regurgitation (IMR) and coronary artery disease (n=100). Mitral valve repair (MVr) with concomitant CABG vs. Mitral valve replacement (MVR) with concomitant CABG was evaluated on Post-operative residual mitral regurgitation (p=<0.001). Mitral valve repair with concomitant CABG resulted in a significantly higher incidence of residual or recurrent mitral regurgitation compared to mitral valve replacement (p<0.001), with no significant difference in early mortality.

synapsesocial.com/papers/6a0e147eaf86e8b097c8275fhttps://doi.org/10.59299/2537-0928.1064
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Short Term Outcome &amp; Surgical Risk of Patients Undergoing Mitral Valve Repair vs Replacement in Severe Ischemic Mitral Regurgitation2025
  2. 2The Impact of Mitral Valve Replacement in Treating Moderate-to-Severe Ischemic Mitral Regurgitation on Preservation of the Left Ventricular Function2024
  3. 3Should the mitral valve be repaired for moderate ischemic mitral regurgitation at the time of revascularization surgery?2018 · 23 citations
  4. 4Impact of additive mitral valve surgery to coronary artery bypass grafting on mortality in patients with coronary artery disease and ischaemic mitral regurgitation: a systematic review and meta-analysis of randomized trials and observational studies2015 · 1 citations
  5. 5Mitral Regurgitation and Coronary Artery Bypass Surgery: Comparison of Mitral Valve Repair and Replacement2013 · 10 citations