Factors determining early mortality in ischemic mitral regurgitation surgery

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery Outcomes
• Mitral Valve Disease

Background:

• Ischemic mitral regurgitation (IMR) necessitates complex surgical intervention.
• Combined mitral valve surgery and coronary artery bypass grafting (CABG) are performed for IMR.
• Identifying early mortality causes in these patients is critical for improving surgical results.

Purpose of the Study:

• To determine the factors contributing to early mortality in patients undergoing combined mitral valve surgery and CABG for IMR.
• To analyze the impact of surgical timing and patient characteristics on in-hospital mortality.

Main Methods:

• Retrospective analysis of 411 patients who underwent combined mitral valve surgery and CABG for IMR between January 2017 and January 2023.
• Patients were categorized based on in-hospital mortality.
• Statistical analysis was performed to identify independent risk factors for mortality.

Main Results:

• In-hospital mortality rate was 13.6% (n=56).
• Independent risk factors for mortality included advanced age, female sex, priority (emergency) surgery, low ejection fraction, elevated creatinine, extracardiac arteriopathy, and prolonged cardiopulmonary bypass time.
• In priority cases, a waiting period of ≤9 days was associated with significantly higher mortality.

Conclusions:

• Comprehensive preoperative evaluation is essential for optimizing outcomes in IMR patients.
• Less invasive approaches may be considered for high-risk individuals.
• A waiting period of up to nine days for priority cases, if hemodynamically stable, may reduce mortality.