Related Experiment Video

Updated: Jun 26, 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

Revascularization for Coronary Artery Disease and Mitral Regurgitation: A Systematic Review and Meta-analysis

Ryaan El-Andari1, Ashlyn Kruggel1, Mitchell Wagner2

  • 1From the Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB.

Annals of Surgery Open : Perspectives of Surgical History, Education, and Clinical Approaches
|June 25, 2026
PubMed

Insights

Coronary artery bypass grafting (CABG) is associated with lower long-term mortality and heart failure hospitalizations compared to percutaneous coronary intervention (PCI) in patients with multivessel coronary artery disease and ischemic mitral regurgitation. CABG is recommended for eligible patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Coronary artery disease (CAD) and ischemic mitral regurgitation (IMR) frequently coexist.
  • Optimal treatment strategies for patients with both conditions remain unclear.

Purpose of the Study:

  • To compare the outcomes of coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) in patients with multivessel CAD and IMR.
  • To evaluate long-term mortality, myocardial infarction, stroke, heart failure hospitalizations, and mitral regurgitation recurrence.

Main Methods:

  • Systematic review and meta-analysis of studies comparing CABG and PCI for multivessel CAD with IMR.
  • Searched PubMed and Embase databases.
  • Included 8 studies after full-text review of 1285 identified articles.

Main Results:

  • Initial pooled analysis showed no significant difference in long-term mortality, with considerable heterogeneity.
  • Exclusion of an outlier improved heterogeneity, favoring CABG over PCI for mortality (OR: 1.39, 95% CI: 1.06-1.83).
  • Rehospitalization for heart failure also significantly favored CABG (OR: 1.49, 95% CI: 1.16-1.92).

Conclusions:

  • CABG demonstrated lower rates of long-term mortality and heart failure hospitalizations compared to PCI.
  • CABG is the preferred revascularization strategy for patients with multivessel CAD and IMR who have acceptable surgical risk.
Abstract

Keywords:
coronary artery bypass graftingcoronary artery diseaseischemic mitral regurgitationpercutaneous coronary intervention

More Related Videos

An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat07:42

An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat

Published on: May 19, 2020

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

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...
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...
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...
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...
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...
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...