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Coronary artery bypass on survival in patients with moderate ischemic mitral regurgitation: meta-analysis

Jing Lv1, Kai Liu2, Ruoyi Lu2

  • 1Department of General Medicine.

Cirugia Y Cirujanos
|March 29, 2022
PubMed

Insights

Combining mitral valve surgery with coronary artery bypass grafting (CABG) offers no survival benefit over CABG alone for patients with moderate ischemic mitral valve regurgitation. This meta-analysis found no significant differences in short- or long-term survival rates.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Mitral Valve Disease

Background:

  • Ischemic mitral valve regurgitation (IMVR) is a common complication after myocardial infarction.
  • Surgical intervention for IMVR, including isolated coronary artery bypass grafting (CABG) or CABG combined with mitral valve surgery (cMVS), is debated.
  • Evaluating the impact of these procedures on patient survival is crucial for clinical decision-making.

Purpose of the Study:

  • To systematically evaluate the comparative effect of CABG versus cMVS on post-operative survival in patients with moderate IMVR.
  • To synthesize evidence from existing studies to inform treatment strategies for IMVR.

Main Methods:

  • A comprehensive literature search was conducted across major databases (PubMed, Web of Science, Cochrane Library, WanFang Data, CNKI Data) up to January 2020.
  • Included studies were screened based on predefined criteria, and data were extracted.
  • A meta-analysis was performed using RevMan 5.2 to compare survival outcomes between the CABG and cMVS groups.

Main Results:

  • The meta-analysis included 4 randomized controlled trials and 14 retrospective studies, totaling 4476 patients (2278 in CABG group, 1698 in cMVS group).
  • No statistically significant differences were observed in recent mortality (OR = 0.88, p = 0.62), 1-year survival (OR = 1.03, p = 0.82; OR = 1.07, p = 0.62), or long-term survival (OR = 0.95, p = 0.61) between the cMVS and CABG groups.
  • These findings suggest that adding mitral valve surgery to CABG does not improve survival outcomes.

Conclusions:

  • Current evidence indicates that combining mitral valve surgery with CABG does not confer a survival advantage compared to CABG alone in patients with moderate ischemic mitral valve regurgitation.
  • Further research may be warranted to explore other potential benefits or specific patient subgroups that might benefit from cMVS.
Abstract

Keywords:
Cirugía de revascularización coronariaCoronary artery bypass graftingInsuficiencia mitral isquémicaIschemic mitral regurgitationMeta-analysisMetaanálisis

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