Ring annuloplasty in chronic ischemic mitral regurgitation: Encouraging early and midterm results

Tekumit H., Cenal A. R., Uzun K., Tataroglu C., Akinci E.

Texas Heart Institute Journal, cilt.36, sa.4, ss.287-292, 2009 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 36 Sayı: 4
  • Basım Tarihi: 2009
  • Dergi Adı: Texas Heart Institute Journal
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.287-292
  • Anahtar Kelimeler: Cardiac surgical procedures, Chronic disease, Coronary artery bypass/mortality, Coronary disease/complications/mortality/surgery, Mitral valve insufficiency/complications/mortality/ physiopathology/surgery, Mitral valve/surgery, Myocardial infarction/complications/mortality/ physiopathology/surgery, Myocardial revascularization, Postoperative complications/mortality, Prognosis
  • İstanbul Gelişim Üniversitesi Adresli: Hayır

Özet

Ischemic mitral regurgitation, a complication of myocardial infarction, is associated with a poor prognosis and can result in postinfarction congestive heart failure. The preferred treatment of its chronic form is a matter of debate. Herein, we report the early and midterm results in 44 patients with chronic ischemic mitral regurgitation in whom concomitant mitral ring annuloplasty and coronary revascularization were performed at our hospital. We reviewed their medical records. The patients had grades 3/4 and 4/4 chronic ischemic mitral regurgitation, or grade 2/4 regurgitation with left ventricular dilation and low left ventricular ejection fraction. All received circular, flexible annuloplasty rings. Four patients died during the early postoperative period due to low cardiac output (9.1%). At the last follow-up echocardiographic examinations, performed a mean 13.14 ± 4.66 months after the surgical procedures (range, 6-22 mo), the 40 surviving patients were found to have significantly reduced left ventricular end-diastolic (P=0.029) and end-systolic (P <0.05) diameters and improved New York Heart Association functional class (P=0). Despite a risk of residual regurgitation, mitral ring annuloplasty appears to be a good treatment alternative in selected patients who have chronic ischemic mitral regurgitation. We discuss the procedure's rate of hospital mortality, and its potentially positive impact on survival. © 2009 by the Texas Heart® Institute.