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Year : 2019  |  Volume : 32  |  Issue : 2  |  Page : 592-598

Clinical implications of moderate ischemic mitral regurgitation in patients undergoing coronary artery bypass grafting

1 Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Shibin-El-Kom, Egypt
2 Department of Cardiothoracic Surgery, National Heart Institute, Cairo, Egypt
3 Department of Cardiac Surgery, El-Mahalla Cardiac Center, El-Mahalla El-Kubra, Gharbia Governorate, Egypt

Correspondence Address:
Yasser F Asswaf
El-Mahalla El-Kubra 31951, Gharbia Governorate
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mmj.mmj_690_17

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Objective The aim of this study was to explore the fate of moderate ischemic mitral regurgitation (IMR) following isolated coronary artery bypass grafting (CABG). Background IMR is a frequently encountered problem seen in patients with coronary artery disease. A much-debated question is whether surgical revascularization alone will correct moderate (2+) IMR in such patients. Patients and methods The study group included 20 patients with moderate IMR associated with coronary artery disease undergoing isolated CABG. All patients had an ejection fraction of more than 30%. The patients were clinically and echocardiographically evaluated preoperatively, 1 week postoperatively and at 3- and 6-month intervals. Results CABG alone reduced the degree of IMR in 12 (60%) patients, did not improve it in five (25%) patients, and increased its degree to 3–4 + in three (15%) patients at 6-month follow-up echocardiography. Our study showed improved functional capacity of the patients. A significant reduction in the New York Heart Association functional class was observed. The mean preoperative value for New York Heart Association was 2.45 ± 0.51 versus 2.05 ± 0.88 postoperatively (P = 0.042). Some important variables showed a role in the progression of IMR. These were: left ventricular end-systolic dimension, left ventricular end-diastolic dimension, preoperative ejection fraction%, and failure to graft the diseased right coronary system. Conclusion The presence of moderate IMR in patients undergoing revascularization alone does not add additional burden to the operative risk nor does it affect the short-term outcome of these patients.

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