Concomitant Off-Pump Coronary Artery Bypass Grafting Results in Improved In-Hospital Outcomes for Patients with Ischemic Mitral Regurgitation Undergoing Surgery

Authors

  • Shahzad G. Raja
  • Mubassher Husain
  • Kareem Salhiyyah
  • Manoraj Navaratnarajah
  • Dimple Chudasama
  • Christopher P. Walker
  • Fouad Amin
  • Mohamed Amrani

DOI:

https://doi.org/10.1532/HSF98.20121039

Abstract

Objective: Surgical management of ischemic mitral regurgitation (IMR) has primarily consisted of revascularization with or without the addition of mitral valve repair or replacement. We hypothesize that performing off-pump coronary artery bypass (OPCAB) grafting before fixing MR improves in-hospital outcomes for patients with IMR undergoing surgery.

Methods: From January 2000 through December 2010, a total of 96 consecutive patients with moderate or severe IMR, as determined by preoperative echocardiography, underwent on-pump coronary artery bypass grafting (CABG) (n = 66) or OPCAB (n = 30) revascularization with concomitant mitral valve repair or replacement. A retrospective analysis of a prospectively collected cardiac surgery database (PATS; Dendrite Clinical Systems, Oxford, UK) was performed. In addition, medical notes and charts were reviewed for all study patients.

Results: The 2 groups had similar preoperative demographic and EuroSCORE risk-stratification characteristics. The operative mortality rate for the entire cohort was 9.4%. Patients who underwent OPCAB grafting had a lower operative mortality than those who underwent CABG (3.3% versus 12.1%; P = .006). The mean ±SD cardiopulmonary bypass time (82.7 ± 34.7 minutes versus 160.7 ± 45.2 minutes; P < .001) and cross-clamp time (49.0 ± 22.4 minutes versus 103.4 ± 39.5 minutes; P < .001) were significantly shorter in the off-pump group than in the on-pump group. The OPCAB group also had significantly less in-hospital morbidity and shorter stays in the intensive care unit and the hospital.

Conclusion: Our analysis shows that OPCAB grafting (compared with conventional CABG) before repairing MR is associated with favorable in-hospital outcomes for patients undergoing surgery for IMR.

References

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Published

2013-02-25

How to Cite

Raja, S. G., Husain, M., Salhiyyah, K., Navaratnarajah, M., Chudasama, D., Walker, C. P., Amin, F., & Amrani, M. (2013). Concomitant Off-Pump Coronary Artery Bypass Grafting Results in Improved In-Hospital Outcomes for Patients with Ischemic Mitral Regurgitation Undergoing Surgery. The Heart Surgery Forum, 16(1), E15-E20. https://doi.org/10.1532/HSF98.20121039

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