The Progress of Mitral Regurgitation after Isolated Coronary Artery Bypass in Cases of Ischemic Mitral Regurgitation

BACKGROUND: Mitral valve intervention combined with coronary artery bypass surgery is inevitable in the case of severe mitral regurgitation in patients with coronary artery disease because the prognosis is poor without mitral correction. The best treatment protocol for patients with a moderate degree of mitral regurgitation is under debate. To clarify the optimal management for these patients, we evaluated the progress of mitral regurgitation after isolated coronary artery bypass surgery in cases of ischemic mitral regurgitation. METHODS; The study was conducted between March 2001 and April 2003. Forty-seven patients (70% men, with a mean age of 61 years, a mean ejection fraction of 43.7%, and a mean New York Heart Association class of 2.53) with preoperative diagnoses of moderate degree ischemic mitral regurgitation (Grade 3 mitral regurgitation on a scale of 0 to 4) and coronary artery disease, without leaflet pathology, underwent isolated coronary artery bypass surgery. Patients were followed-up at a mean of 22 months and an echocardiographic evaluation was done to determine the progress of the mitral disease. RESULTS: The 30-day operative mortality rate was 2.1%. In the postoperative period, the mean ejection fraction was 46.9% and the mean functional capacity of the patients was 1.31. Mitral regurgitation regressed to a mild degree in 56.9% of the patients. The 2-year survival rate was 93.7%. CONCLUSIONS: Patients with moderate ischemic mitral regurgitation and coronary artery disease who underwent coronary artery bypass surgery alone had acceptable results. We are of the opinion that isolated coronary artery bypass surgery might be a good treatment choice for moderate degree ischemic mitral regurgitation.