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Do age, diabetes and left ventricular function affect the outcomes of ischemic mitral valve repair?

Loreta Jankauskiene1, Milda Svagzdiene1, Edmundas Sirvinskas1

  • 1Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania ; Clinic of Cardiothoracic and Vascular Surgery, Lithuanian University of Health Sciences, Medical Academy Hospital, Kaunas, Lithuania.

Kardiochirurgia I Torakochirurgia Polska = Polish Journal of Cardio-Thoracic Surgery
|September 4, 2015
PubMed

Insights

Elderly age, diabetes mellitus, and low ejection fraction do not impact mortality after coronary artery bypass grafting with mitral valve repair. Diabetes mellitus, however, increases perioperative myocardial infarction risk.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Mitral Valve Repair

Background:

  • Older age, comorbidities like diabetes mellitus (DM), and impaired left ventricular function increase risks after coronary artery bypass grafting (CABG) and mitral valve (MV) repair for ischemic mitral regurgitation (MR).
  • Understanding the impact of these factors is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To evaluate the influence of age, DM, and left ventricular ejection fraction (LVEF) on early and late outcomes following CABG with MV repair.
  • To identify specific risk factors affecting postoperative complications and mortality.

Main Methods:

  • Retrospective analysis of 394 patients undergoing CABG and MV repair.
  • Patients were stratified by age, DM status, and LVEF.
  • Comparison of echocardiography data, complication rates (including sepsis, MI, stroke), and mortality between groups.

Main Results:

  • No significant differences in mortality or early postoperative outcomes were observed based on age, DM, or LVEF.
  • Patients with DM showed a higher rate of perioperative myocardial infarction (MI) compared to those without DM.
  • Reverse remodeling of the left ventricle was more pronounced in patients with lower LVEF, but DM impaired this process.

Conclusions:

  • Elderly age, concomitant DM, and reduced LVEF do not adversely affect early or late mortality after MV repair for ischemic MR in CABG patients.
  • Concomitant DM is associated with an increased risk of perioperative MI and impaired left ventricular reverse remodeling.
  • These findings suggest that while these factors may not influence mortality, specific complications like MI are more prevalent in diabetic patients.
Abstract

Keywords:
cardiac surgery procedurescomplicationsischemic mitral valve repairrisk factors

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