[The surgical treatment of chronic ischemic mitral insufficiency]

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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

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R Scrofani1, A Cialfi, S Ravagnan

  • 1Divisione di Chirurgia Toracica e Cardiovascolare, Ospedale L. Sacco, Milano.

Giornale Italiano Di Cardiologia
|May 18, 1999
PubMed

Insights

Surgical treatment for chronic ischemic mitral regurgitation (CIMR) is feasible with acceptable risks. Mid-term results show favorable functional outcomes, though the best surgical approach (repair vs. replacement) remains debated.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Research

Background:

  • Chronic ischemic mitral regurgitation (CIMR) presents a high-risk surgical challenge.
  • Evaluating the efficacy of surgical interventions for CIMR is crucial for patient outcomes.

Purpose of the Study:

  • To assess the short- and long-term results of surgical treatment for chronic ischemic mitral regurgitation (CIMR).

Main Methods:

  • A retrospective study of 46 patients undergoing mitral valve replacement or repair for CIMR between 1989 and 1997.
  • Procedures included myocardial revascularization in 91.3% of patients.
  • Preoperative assessment included echocardiography, New York Heart Association (NYHA) functional class, and ejection fraction (EF).

Main Results:

  • Overall operative mortality was 8.6%, with higher mortality for valve replacement (16.6%) than repair (5.8%).
  • Postoperative morbidity included low output syndrome (15.2%) and cerebral embolism (4.3%).
  • At a mean follow-up of 27.6 months, 86.4% of patients achieved I-II NYHA functional class, with two late deaths.

Conclusions:

  • Surgical treatment for CIMR is achievable with acceptable operative risks.
  • Mid-term functional and clinical outcomes are promising.
  • The optimal surgical strategy, whether valve repair or replacement, requires further investigation.
Abstract

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