Key result
CABG with mitral valve repair reduced long-term total complications (23.5% vs 52.7%, p=0.015) and improved 3-year survival (74% vs 45%, p=0.037) compared to isolated CABG in ischemic cardiomyopathy.
Why the study?
The study aimed to identify risk factors for mitral insufficiency recurrence after isolated CABG and after CABG with mitral valve repair in patients with ischemic cardiomyopathy and moderate mitral insufficiency.
RCT (n=76)
Open-label
1:1 ratio
No
Answers are grounded in this paper and cite their sources.
May support mitral repair addition to CABG in ischemic cardiomyopathy; leaves open confirmation by randomized trials.
Background and Objective: This study aimed to identify risk factors for mitral insufϐiciency (MI) recurrence after isolated coronary artery bypass grafting (CABG) and for CABG with mitral valve (MV) repair of moderate MI in patients with ischemic cardiomyopathy. Methodology: This is a single-centre prospective study. We included 76 patients with moderate MI and poor left ventricular function (EF <35%). The patients underwent isolated CABG or CABG with MV repair. The age of the patients was 57±8 years, and 90% were men. MV repair was restricting annuloplasty using a rigid ring with a size of 26–30. Results: The total complications in the long-term period were 19 (52.7%) and 8 (23.5%) in the isolated CABG and CABG + MV repair groups, respectively (p=0.015). After isolated CABG in patients suffering ischemic cardiomyopathy (IC) and moderate MI, progression of MI (grade 3) initially 0%, after 12 months, 31%, after 36 months, 71%, p <0.001 is observed. Conclusions: Isolated CABG or CABG with MV repair in patients with IC does not result in a signiϐicant decrease in MI in the long-term, when compared with the baseline. The revealing of the predictors of the progression of MI made it possible to determine the threshold values of the performance indicators of MV repair and assisted with the determination of the surgical treatment strategies for patients with moderate MI.
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Эфендиев et al. (2021) conducted an RCT in Ischemic cardiomyopathy with moderate mitral insufficiency and LVEF <35% (n=76). CABG with mitral valve repair (restricting annuloplasty with a rigid ring size 26-30) vs. Isolated CABG was evaluated on Total long-term complications (combined endpoint of stroke, sudden cardiac death, progressive heart failure, and annuloplastic ring detachment at 3 years) (RR 2.24 (CABG vs CABG + MV repair), p=0.015). CABG with mitral valve repair reduced long-term total complications (23.5% vs 52.7%, p=0.015) and improved 3-year survival (74% vs 45%, p=0.037) compared to isolated CABG in ischemic cardiomyopathy.
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