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Predictors of moderate ischemic mitral regurgitation improvement after off-pump coronary artery bypass

Xiaotian Sun1, Jiechun Huang1, Meng Shi1

  • 1Department of Cardiothoracic Surgery, Huashan Hospital of Fudan University, Shanghai, P. R. China.

The Journal of Thoracic and Cardiovascular Surgery
|April 13, 2015
PubMed

Insights

Off-pump coronary artery bypass grafting can improve moderate ischemic mitral regurgitation. Key predictors include preserved ejection fraction, favorable posterior-inferior volume ratio, and early surgery after infarction.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Cardiovascular Imaging

Background:

  • Moderate ischemic mitral regurgitation (IMR) is a common complication after myocardial infarction.
  • Off-pump coronary artery bypass grafting (OPCAB) is a surgical option for patients with coronary artery disease and IMR.
  • Predictors of IMR improvement after OPCAB require further elucidation.

Purpose of the Study:

  • To identify predictors of moderate IMR improvement following OPCAB.
  • To analyze the impact of left ventricular remodeling and function on IMR outcomes post-OPCAB.

Main Methods:

  • A prospective study of 109 patients with moderate IMR undergoing OPCAB.
  • Preoperative and 1-year postoperative clinical and echocardiographic data were collected.
  • Patients were categorized into improved (no/mild IMR) and failure (moderate/severe IMR) groups.

Main Results:

  • At 1-year follow-up, 55 patients improved and 49 experienced failure.
  • Preoperative factors predicting improvement included smaller left ventricular end-systolic volume, greater ejection fraction, and greater posterior-inferior volume ratio.
  • Earlier operation timing post-infarction was also a significant predictor of IMR improvement.

Conclusions:

  • OPCAB can effectively relieve moderate IMR in selected patients.
  • Greater ejection fraction, posterior-inferior volume ratio, and early revascularization are crucial for predicting IMR improvement.
  • Posterior-inferior regional remodeling, preserved ventricular function, and timely revascularization are vital for successful outcomes.
Abstract

Keywords:
coronary artery bypass graftingmitral regurgitationmyocardial infarctionmyocardial remodeling

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