Journal of Shanghai Jiao Tong University (Medical Science) ›› 2022, Vol. 42 ›› Issue (5): 629-634.doi: 10.3969/j.issn.1674-8115.2022.05.011

• Clinical research • Previous Articles     Next Articles

Surgical treatment of moderate ischemic mitral regurgitation complicated with reduced left ventricular ejection fraction

YAO Haoyi(), LIU Yun, QIN Kaijie, ZHOU Mi, WANG Zhe, CHEN Anqing, ZHAO Qiang, LI Haiqing()   

  1. Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
  • Received:2021-11-29 Accepted:2022-04-28 Online:2022-05-28 Published:2022-05-28
  • Contact: LI Haiqing E-mail:leon780_cn@sina.com;drlihaiqing@163.com

Abstract: Objective

·To explore different surgical strategies in patients of moderate ischemic mitral regurgitation (IMR) complicated with reduced left ventricular ejection fraction (LVEF).

Methods

·From May 2013 to May 2019, 31 patients diagnosed as moderate IMR with LVEF <50% received surgical treatment in Department of Cardiovascular Surgery in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. The patients were divided into off-pump coronary artery bypass grafting (OPCABG) group and CABG+mitral valve plasty (MVP) group according to whether or not mitral valve procedure was performed. Preoperative, postoperative and follow-up echocardiography data and perioperative complications were compared to evaluate the surgical efficacy.

Results

·There were 12 patients in OPCABG group and 19 patients in CABG+MVP group. 1 patient died in CABG+MVP group postoperatively, which showed no significant difference in mortality (5.3% vs 0) between the groups. The degree of mitral regurgitation was significantly reduced in CABG+MVP group (P=0.000), while intensive care unit (ICU) length of stay significantly increased [3.0 (1.0, 4.0) d vs 1.0 (1.0, 2.0) d, P=0.027]. After 48.7 (30.2, 66.5) months of follow-up, there were no significant differences in mortality, degree of mitral regurgitation, LVEF and complications between the two groups.

Conclusion

·OPCABG procedure treating chronic moderate IMR with reduced LVEF could be beneficial for enhanced recovery after surgery and has satisfactory early and mid-term efficacy.

Key words: ischemic mitral regurgitation, reduced left ventricular ejection fraction, off-pump coronary artery bypass grafting, mitral valve annuloplasty, enhanced recovery after surgery

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