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DOI: 10.1055/s-2005-922393
Coronary artery bypass grafting and moderate mitral regurgitation
Introduction: There is general agreement that patients with severe mitral regurgitation (MI) should undergo mitral valve sugery at the time of coronary artery bypass grafting (CABG). However the importance of moderate MI in such patients is controversial. Therefore, we investigate the course of our patients with moderate MI after CABG surgery alone or with CABG and mitral valve surgery.
Methods: From 01/2001 to 11/2004 147 patients with moderate MI underwent CABG alone (group A, n=77) or CABG and mitral valve surgery (group B, n=70). Group A included 43 men (55%), and mean age was 70 years (range 40 to 85) compared to 50 men (60%) (mean age 71 years; range 35 to 84 years).
Results: Postoperative echocardiography was performed in 28 patients (36%) in group A, compared to 41 patients, who underwent mitral valve repair. In group A MI was absent in 14%, mild in 36% and severe 50% vs. 69%, 29% and 2%, respectively. 7 patients died in group A vs. 9 patients in group B (p=ns), caused by low cardiac output (5 vs. 6), by multiorganfailure (1 vs. 3) and by malignant arrhythmia (1).
Conclusions: Patients with moderate MI undergoing cardiac surgery present a high risk group. There is no difference between the two groups concerning postoperative mortality and morbidity. Since moderate MI does not reliable resolve in a substantial percentage of patients, it would be important to clarify in a randomized prospective trial, which patients will benefit from mitral valve surgery. Our data could suggest a low threshold for mitral valve repair.