Key result
LV restoration in moderate-to-severe MR is linked to ~18% hospital mortality and lower 5-year survival.
Why the study?
The surgical management of mitral regurgitation associated with ischemic cardiomyopathy remains controversial due to its impact on heart failure severity.
What are the surgical outcomes of left ventricular restoration combined with mitral valve procedures in patients with ischemic cardiomyopathy and moderate to severe mitral regurgitation compared to those without significant mitral regurgitation?
Comparison
LV restoration with CABG and mitral valve procedure in moderate to severe MR vs LV restoration with CABG in none or mild MR
Design
Cohort study
Follow-up
5 years
Authors
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Indicates elevated perioperative risk with LV restoration in moderate-severe MR; leaves open optimal surgical strategy pending prospective trials.
Cohort (n=92)
What are the surgical outcomes of left ventricular restoration combined with mitral valve procedures in patients with ischemic cardiomyopathy and moderate to severe mitral regurgitation compared to those without significant mitral regurgitation?
Absolute Event Rate: 18.4% vs 3.7%
In patients with ischemic cardiomyopathy, combined mitral valve surgery with LV restoration and CABG for moderate-to-severe MR is associated with higher perioperative mortality but provides symptomatic improvement and acceptable 5-year survival.
Isomura et al. (2003) conducted a cohort in Ischemic cardiomyopathy (n=92). Moderate to severe mitral regurgitation vs. None or mild mitral regurgitation was evaluated on Hospital mortality. Patients with ischemic cardiomyopathy and moderate to severe mitral regurgitation undergoing LV restoration had higher hospital mortality (18.4% vs 3.7%) and lower 5-year survival (60.9% vs 70.1%).
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