Related Experiment Video

Updated: May 3, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
08:31

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

Published on: October 16, 2021

3.7K

Incidental moderate mitral regurgitation in patients undergoing coronary artery bypass grafting: update on guidelines

Harish Ramakrishna1, Kamrouz Ghadimi2, John G T Augoustides2

  • 1Mayo Clinic, Scottsdale, AZ.

Journal of Cardiothoracic and Vascular Anesthesia
|January 21, 2014
PubMed

Insights

Moderate mitral regurgitation (MR) in patients undergoing coronary artery bypass grafting (CABG) may worsen outcomes. New trials and interventions are emerging, suggesting less tolerance for MR in the future.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Incidental moderate mitral regurgitation (MR) is common in patients undergoing coronary artery bypass grafting (CABG).
  • This condition may adversely affect clinical outcomes.
  • Echocardiographic evaluation of MR is crucial for management decisions.

Purpose of the Study:

  • To review the current understanding and management of incidental moderate MR in patients undergoing CABG.
  • To discuss the implications of ongoing clinical trials and emerging interventions.

Main Methods:

  • Review of current guidelines and clinical practice.
  • Discussion of ongoing randomized trials comparing CABG with and without mitral intervention.
  • Overview of advancements in cardiac resynchronization therapy, transcatheter mitral valve intervention, and minimally invasive surgery.

Main Results:

  • Clinical equipoise exists regarding moderate MR in the context of planned CABG.
  • Two major randomized trials are underway to assess the benefits of combined surgical correction of moderate MR and CABG.
  • Advancements in cardiac interventions offer new management alternatives.

Conclusions:

  • Surgical mitral intervention is a reasonable option for moderate MR during CABG.
  • Emerging therapies promise improved safety profiles and management options.
  • Future management will likely involve less tolerance for incidental moderate MR due to known outcome effects and evolving interventions.

Keywords:
cardiac resynchronization therapyclinical equipoiseclinical outcomescoronary artery bypass graftingechocardiographyeffective orifice areaguidelinesminimally invasive mitral valve surgerymitral valve repairmitral valve replacementmoderate mitral regurgitationrandomized trialsregurgitant fractionregurgitant volumetranscatheter mitral valve interventionvena contracta

More Related Videos

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

2.9K
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement08:50

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

10.9K

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...
686
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...
535
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...
602
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...
943
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
598
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...
1.3K