Ischemic mitral valve regurgitation grade II-III: Correction in patients with impaired left ventricular function undergoing simultaneous coronary revascularization

Background and aim of the study: Mitral valve regurgitation (MVR), occurring as a result of myocardial ischemia and global left ventricular (LV) dysfunction, is predictive of poor outcome. The study aim was to assess the feasibility of mitral valve surgery concomitant with coronary artery bypass grafting (CABG) in patients with ischemic MVR grade II-III and impaired LV function. Methods: Between January 1996 and July 2000, 99 patients with grade II and III ischemic MVR and LV ejection fraction (LVEF) 17-30% underwent either combined mitral valve surgery and CABG (group I, n = 49) or isolated CABG (group II, n = 50). LVEF (%), LV end-diastolic diameter (LVEDD; mm), LV end-diastolic pressure (LVEDP; mmHg), LV end-systolic diameter (LVESD; mm) respectively were 27.5 ± 5, 67.7 ± 7, 27.7 ± 4 and 51.4 ± 7 in group I versus 27.8 ± 4, 67.5 ± 6, 27.5 ± 5 and 51.2 ± 6 in group II. In group I, mitral valve repair was performed in 43 patients (88%) and replacement in six (12%). Results: Preoperative data analysis showed no difference between groups. Five patients (10%) died in group I, compared with six (12%) in group II (p = NS). Within six months of surgery, LV function and geometry improved significantly in group I versus group II (LVEF, p