Year : 2015 | Volume
: 28 | Issue : 1 | Page : 114--120
Revascularization versus revascularization and repair in moderate chronic ischemic mitral regurgitation: a randomized trial
Ahmed L Dokhan1, Mohamed A Khalil2, Mostafa F Abu ollo1, Mohamed T Abdulmonem3
1 Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menouifa, Egypt
2 Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
3 Department of Cardiothoracic Surgery, National Heart Institute, Cairo, Egypt
The goal of this study was to determine whether the surgical management of moderate chronic ischemic mitral regurgitation (IMR) is to revascularize only or to revascularize and perform mitral valve repair as well.
Ischaemic mitral regurgitation is a frequent complication of left ventricular global or regional pathological remodeling due to chronic coronary artery disease. Although there are numerous possible treatment modalities, the management of patients with moderate chronic IMR remains uncertain.
Patients and methods
Forty patients referred for coronary artery bypass grafting with moderate IMR and an ejection fraction more than 30% were randomized to receive coronary revascularization plus mitral valve repair (20 patients) or revascularization only (20 patients). Survivors were clinically and echocardiographically assessed early postoperatively and at 3 months«SQ» follow-up.
There was no significant difference between the two groups as regards preoperative and demographic data. The operative time, ventilation time, and ICU stay were significantly higher in the repair group. Use of cardiac supports, complications, in-hospital mortality, and ward stay were not statistically significantly different. Postoperative and follow-up echocardiographic data showed no statistically significant difference in left atrial dimension, left ventricular dimension, and function between the two groups. Although the grade of mitral regurgitation showed improvement in both groups, there was significantly higher improvement in the repair group compared with the revascularization-only group.
Adding mitral repair to coronary revascularization in patients with moderate IMR may improve mitral regurgitation severity without additional risk. Improvement in functional capacity and left ventricular reverse remodeling was observed in both procedures.
Mohamed T Abdulmonem
Cardiothoracic Surgery Department, National Heart Institute, Cairo
|How to cite this article:|
Dokhan AL, Khalil MA, Abu ollo MF, Abdulmonem MT. Revascularization versus revascularization and repair in moderate chronic ischemic mitral regurgitation: a randomized trial.Menoufia Med J 2015;28:114-120
|How to cite this URL:|
Dokhan AL, Khalil MA, Abu ollo MF, Abdulmonem MT. Revascularization versus revascularization and repair in moderate chronic ischemic mitral regurgitation: a randomized trial. Menoufia Med J [serial online] 2015 [cited 2020 Feb 22 ];28:114-120
Available from: http://www.mmj.eg.net/article.asp?issn=1110-2098;year=2015;volume=28;issue=1;spage=114;epage=120;aulast=Dokhan;type=0