Related Experiment Video

Updated: Jun 19, 2026

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

Coronary revascularization alone or with mitral valve repair: outcomes in patients with moderate ischemic mitral

Sorel Goland1, Lawrence S C Czer, Robert J Siegel

  • 1Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.

Texas Heart Institute Journal
|October 31, 2009
PubMed

Insights

Coronary artery bypass grafting (CABG) with or without mitral valve repair (MVr) improved patient function. While both approaches showed similar survival, CABG+MVr had higher rates of recurrent mitral regurgitation long-term.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Medicine
  • Interventional Cardiology

Background:

  • Moderate ischemic mitral regurgitation (IMR) often coexists with coronary artery disease.
  • Surgical management decisions for IMR remain complex, balancing risks and benefits.

Purpose of the Study:

  • To compare outcomes of coronary artery bypass grafting (CABG) alone versus CABG with concomitant mitral valve repair (CABG+MVr) in patients with moderate IMR.
  • To evaluate the impact of surgical strategy on mitral regurgitation severity, functional status, and survival.

Main Methods:

  • Retrospective analysis of 83 patients with reduced ejection fraction and moderate IMR.
  • Comparison of outcomes between 28 patients undergoing CABG+MVr and 55 patients undergoing CABG alone.
  • Assessment of mitral regurgitation, functional class, and ejection fraction changes over a mean follow-up of 5.1 years.

Main Results:

  • Both CABG and CABG+MVr improved functional class and ejection fraction.
  • Early and intermediate-term survival rates were similar between groups (1-year: 96%, 5-year: 81-87%).
  • CABG+MVr showed greater initial reduction in mitral regurgitation, but higher rates of late recurrence (22% vs. 47% at late follow-up).

Conclusions:

  • Both CABG and CABG+MVr are effective in improving functional class and survival in moderate IMR.
  • CABG+MVr may lead to a higher incidence of late recurrent mitral regurgitation compared to CABG alone.

Keywords:
Cardiac surgical procedurescoronary artery bypasscoronary disease/complications/surgerydisease-free survival/trendsmatched-pair analysismitral valve insufficiency/physiopathology/surgerymultivariate analysismyocardial ischemia/complications/surgerymyocardial revascularization/methods/statistics & numerical datapostoperative periodrecurrencerisk assessment

More Related Videos

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair08:31

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

Related Concept Videos

Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Mitral Regurgitation IV: Nursing Management01:28

Mitral Regurgitation IV: Nursing Management

Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Mitral Regurgitation II: Clinical Features and Diagnostic Tests01:23

Mitral Regurgitation II: Clinical Features and Diagnostic Tests

Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...