Initial Report of Off-Pump Coronary Artery Bypass Surgery as Sole Therapy for Moderate Ischemic Mitral Regurgitation: Operative and Intermediate-Term Outcome

Authors

  • Kevin M. Harris
  • Avinash Reddy
  • Dorothee Aepplii
  • Betsy Wilson
  • Robert W. Emery

DOI:

https://doi.org/10.1532/HSF98.20041162

Abstract

Background: Patients undergoing on-pump coronary artery bypass surgery (CAB) with coexistent moderate ischemic mitral regurgitation (IMR) have a significant mortality rate compared to patients without MR. The mortality rate is elevated both perioperatively (0%-12% mortality), as well as over a 1- and 2-year postoperative period (15%-25%). It is thought that some patients are best served by off-pump CAB (OPCAB); however, outcomes have not been reported for such patients with coexistent moderate IMR.

Methods: We reviewed the independent database of patients undergoing OPCAB between 1995 and 2002 to find 989 patients, 17 (1.7%) of whom had moderate or moderately severe MR. Patients were contacted and clinical and echocardiographic data were obtained.

Results: The patient group consisted of 11 men and 6 women (age, 65 ± 15 years). The study group had a PA pressure of 52 ± 14, creatinine of 1.6 ± 0.7, and left ventricular ejection fraction of 43 ± 18. Nine patients (53%) had advanced New York Heart Association (class III-IV) heart failure. Mortality rates perioperatively and at 1, 2, and 3 years were 0%, 6.25% (1/16), 12.5% (2/16), and 38% (4/8), respectively. At the time of this report, no patient had returned for a reparative procedure.

Conclusion: In patients felt to be best served by OPCAB with ischemic MR, operative and intermediate mortality rates are remarkably similar to those previously reported for on-pump series. These data underscore the continued need to understand which patients undergoing CAB require mitral valve problems to be addressed at the time of surgery.

References

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Published

2005-03-09

How to Cite

Harris, K. M., Reddy, A., Aepplii, D., Wilson, B., & Emery, R. W. (2005). Initial Report of Off-Pump Coronary Artery Bypass Surgery as Sole Therapy for Moderate Ischemic Mitral Regurgitation: Operative and Intermediate-Term Outcome. The Heart Surgery Forum, 8(2), E89-E93. https://doi.org/10.1532/HSF98.20041162

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