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Results of surgery for mitral insufficiency due to coronary artery disease

T Mori, P Zubiate, A M Mendez

    Israel Journal of Medical Sciences
    |February 1, 1975
    PubMed

    Insights

    For patients with combined mitral and coronary artery disease, adding coronary artery revascularization to mitral valve surgery improves long-term survival and functional capacity, with similar short-term mortality rates.

    Area of Science:

    • Cardiovascular Surgery
    • Cardiac Medicine
    • Interventional Cardiology

    Background:

    • Combined mitral valve disease and coronary artery disease presents complex therapeutic challenges.
    • Surgical decision-making requires careful consideration of risks and benefits for both conditions.

    Purpose of the Study:

    • To evaluate the impact of concurrent coronary artery revascularization on outcomes in patients undergoing mitral valve surgery.
    • To compare short-term and long-term mortality and functional capacity between mitral valve surgery alone versus combined procedures.

    Main Methods:

    • Retrospective analysis of 26 patients with combined mitral and coronary artery disease.
    • Patients were divided into two groups: mitral valve surgery only (Group 1) and mitral valve surgery with coronary artery revascularization (Group 2).
    • Analysis included hospital mortality, late mortality, and functional capacity assessments.

    Main Results:

    • Hospital mortality was similar between the two groups, with higher rates for mitral valve replacement compared to repair.
    • Patients with ejection fractions below 0.4 had a low survival rate (2/10) in Group 2.
    • Late mortality was significantly higher in patients who did not receive revascularization, primarily due to myocardial infarction.
    • Addition of revascularization improved functional capacity.

    Conclusions:

    • Coronary artery revascularization can be safely added to mitral valve surgery in selected patients, even with depressed ventricular function.
    • Combined surgical approach improves long-term survival and functional outcomes compared to mitral valve surgery alone.
    • Mitral valve repair may be associated with better short-term survival than replacement.

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