Key result
CABG alone is linked to improved mitral valve reserve in moderate FMR at 12 months.
Why the study?
The management of moderate functional mitral regurgitation during CABG remains debated, prompting evaluation of mitral valve reserve improvement after CABG alone.
Does CABG alone improve mitral valve reserve and reduce mitral regurgitation severity in patients with functional mitral regurgitation?
Observational (n=104)
Does CABG alone improve mitral valve reserve and reduce mitral regurgitation severity in patients with functional mitral regurgitation?
In patients with functional mitral regurgitation, CABG alone improves mitral valve reserve and reduces mitral regurgitation severity, driven by left ventricular reverse remodeling.
May support CABG alone for mitral valve reserve in moderate FMR; hypothesis-generating pending randomized confirmation.
INTRODUCTION: The treatment of moderate functionalmitral regurgitation (FMR) during coronary artery bypass grafting (CABG) is still debated. Our primary end point was to assess the improvement of "mitral valve reserve" (MVR) after CABG alone as a clinical demonstration of left ventricular (LV) recovery. MATERIALS AND METHODS: Between June 2019 and June 2021, we prospectively enrolled 104 consecutive patients undergoing CABG with moderate FMR. Inclusion criteria were inferior-posterior-lateral wall hypokinesia and revascularization of the circumflex or right coronary artery. MVR was calculated as the ratio between anterior and posterior leaflets' straight length. All patients were followed for 1 year. The improvement of MVR has been considered as a reduction of the ratio between anterior and posterior leaflets straight length. RESULTS: Compared to baseline, mean MVR was significantly reduced both at 6 (2.24 ± 0.95 vs. 1,91 ± 0.6; p = 0,047) and 12 months follow-up (2.24 ± 0.95 vs. 1,69 ± 0.49; p = 0,006). Left ventricular (LV) reverse remodeling, meant as improvement of LV ejection fraction and reduction of LV end-systolic volume index and mitral anulus diameter were evaluated at 6 months and 1 year. Mitral regurgitation grade were also significantly reduced at 6 months (p < .001). CONCLUSION: The benefits of myocardial revascularization in term of improvement of mitral regurgitation's degree can be explained by the changes of MVR. The patients with FMR, who could have more advantages from CABG alone, should be the ones who have LVESVi just moderately increased.
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Ceresa et al. (2022) conducted an observational in moderate functional mitral regurgitation (FMR) (n=104). Coronary artery bypass grafting (CABG) alone vs. Baseline was evaluated on Improvement of mitral valve reserve (MVR) (p=0.006). CABG alone significantly improved mitral valve reserve in patients with moderate functional mitral regurgitation at 12 months compared to baseline (1.69 vs 2.24; p=0.006).
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