Concomitant CABG, Left Ventricular Restoration and Mitral Valve Repair for Ischemic Heart Disease

  • Yin Zhaohua Department of Cardiac Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
  • Feng Wei Department of Cardiac Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
  • Xu Fei Department of Cardiac Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
  • Zhang Jiqiang Department of Cardiac Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
  • Du Junzhe Department of Cardiac Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
  • Song Yangwu Department of Cardiac Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing

Abstract

Aim: To evaluate the effects of combined coronary artery bypass grafting (CABG), surgical left ventricular restoration (LVR), and mitral valve repair (MVP) in treating ischemic heart disease combined with mitral regurgitation; and to evaluate the different strategies of LVR and MVP.
Methods: From January 2001 to December 2015, 61 consecutive patients with left ventricular aneurysm and ischemic mitral regurgitation underwent concomitant CABG, LVR and MVP. We evaluated the clinical and echocardiographic outcomes of the patients. The mean follow-up was 5.8 ± 3.3 years.
Results: The operative mortality was 4.9%. One-, five-, and ten-year survival rates were 95.1%, 86.9%, and 80.3%, respectively. Mitral regurgitation, left ventricular ejection fraction (LVEF), and left ventricular end diastolic diameter (LVEDD) improved significantly after surgery (P < .001). During follow-up, 3 patients (5.2%) had moderate mitral regurgitation and 1 patient (1.9%) had severe mitral regurgitation. The clinical outcomes were not influenced by the LVR technique and MVP approach.
Conclusion: Combined CABG, LVR, and MVP was effective for ischemic left ventricular aneurysm with mitral regurgitation. The procedure was associated with acceptable operative risk and clinical outcomes.

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Published
2016-12-06
Section
Articles